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Lastrucci A, Wandael Y, Orlandi G, Barra A, Chiti S, Gigli V, Marletta M, Pelliccia D, Tonietti B, Ricci R, Giansanti D. Precision Workforce Management for Radiographers: Monitoring and Managing Competences with an Automatic Tool. J Pers Med 2024; 14:669. [PMID: 39063923 PMCID: PMC11278459 DOI: 10.3390/jpm14070669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Optimizing work shifts in healthcare is crucial for maintaining high standards of service delivery and fostering professional development. This study delves into the emerging field of skill-oriented work shift optimization, focusing specifically on radiographers within the healthcare sector. Through the development of Skills Retention Monitoring (SRH), this research aims to enhance skill monitoring, workload management, and organizational performance. In this study, several key highlights emerged: (a) Introduction of the SRH tool: The SRH tool represents a resource-efficient solution that harnesses existing software infrastructure. A preliminary version, focusing on the radiographers' professional profile, was released, and after several months of use, it demonstrated effectiveness in optimizing work based on competency monitoring. (b) The SRH tool has thus demonstrated the capacity to generate actionable insights in the organizational context of radiographers. By generating weekly reports, the SRH tool streamlines activity management and optimizes resource allocation within healthcare settings. (c) Application of a Computer-Assisted Web Interviewing (CAWI) tool for pre-release feedback during a training event. (d) Strategic importance of a maintenance and monitoring plan: This plan, rooted in a continuous quality improvement approach and key performance indicators, ensures the sustained effectiveness of the SRH tool. (e) Strategic importance of a transfer plan: Involving professional associations and employing targeted questionnaires, this plan ensures the customization of the tool from the perspective of each profession involved. This is a crucial point, as it will enable the release of tool versions tailored to various professions operating within the hospital sector. As a side result, the tool could allow for a more tailored and personalized medicine both by connecting the insights gathered through the SRH tool with the right competencies for healthcare professionals and with individual patient data. This integration could lead to better-informed decision making, optimizing treatment strategies based on both patient needs and the specific expertise of the healthcare provider. Future directions include deploying the SRH tool within the Pisa hospital network and exploring integration with AI algorithms for further optimization. Overall, this research contributes to advancing work shift optimization strategies and promoting excellence in healthcare service delivery.
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Affiliation(s)
- Andrea Lastrucci
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (A.L.); (Y.W.); (G.O.); (A.B.); (S.C.); (R.R.)
| | - Yannick Wandael
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (A.L.); (Y.W.); (G.O.); (A.B.); (S.C.); (R.R.)
| | - Giovanni Orlandi
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (A.L.); (Y.W.); (G.O.); (A.B.); (S.C.); (R.R.)
| | - Angelo Barra
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (A.L.); (Y.W.); (G.O.); (A.B.); (S.C.); (R.R.)
| | - Stefano Chiti
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (A.L.); (Y.W.); (G.O.); (A.B.); (S.C.); (R.R.)
| | - Valentina Gigli
- Staff della Direzione Aziendale, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (V.G.); (B.T.)
| | - Massimo Marletta
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (M.M.); (D.P.)
| | - Davide Pelliccia
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy; (M.M.); (D.P.)
| | - Barbara Tonietti
- Staff della Direzione Aziendale, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (V.G.); (B.T.)
| | - Renzo Ricci
- Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy; (A.L.); (Y.W.); (G.O.); (A.B.); (S.C.); (R.R.)
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Karami M, Hafizi N, Nickfarjam AM, Refahi S. Development of minimum data set and dashboard for monitoring adverse events in radiology departments. Heliyon 2024; 10:e30054. [PMID: 38707457 PMCID: PMC11068645 DOI: 10.1016/j.heliyon.2024.e30054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
Background To reduce the risk of errors, patient safety monitoring in the medical imaging department is crucial. Interventions are required and these can be provided as a framework for documenting, reporting, evaluating, and recognizing events that pose a threat to patient safety. The aim of this study was to develop minimum data set and dashboard for monitoring adverse events in radiology departments. Material and methods This developmental research was conducted in multiple phases, including content determination using the Delphi technique; database designing using SQL Server; user interface (UI) building using PHP; and dashboard evaluation in three aspects: the accuracy of calculating; UI requirements; and usability. Results This study identified 26 patient safety (PS) performance metrics and 110 PS-related significant data components organized into 14 major groupings as the system contents. The UI was built with three tabs: pre-procedure, intra-procedure, and post-procedure. The evaluation results proved the technical feasibility of the dashboard. Finally, the dashboard's usability was highly rated (76.3 out of 100). Conclusion The dashboard can be used to supplement datasets to obtain a more accurate picture of the PS condition and to draw attention to characteristics that professionals might otherwise overlook or undervalue.
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Affiliation(s)
- Mahtab Karami
- Clinical Research Development Center of Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Health Information Technology and Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Hafizi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali-Mohammad Nickfarjam
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Technology and Management, School of Allied-Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Soheila Refahi
- Department of Medical Physics, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Zeng A, Gu Y, Ma L, Tao X, Gao L, Li J, Wang H, Jiang Y. Development of Quality Indicators for the Ultrasound Department through a Modified Delphi Method. Diagnostics (Basel) 2023; 13:3678. [PMID: 38132262 PMCID: PMC10743281 DOI: 10.3390/diagnostics13243678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
This study aims to establish precise quality indicators for evaluating and enhancing ultrasound performance, employing a methodology based on a comprehensive review of the literature, expert insights, and practical application experiences. We conducted a thorough review of both the domestic and international literature on ultrasound quality control to identify potential indicators. A dedicated team was formed to oversee the complete indicator development process. Utilizing a three-round modified Delphi method, we sought expert opinions through personalized email correspondence. Subsequently, data from diverse hospital indicators were collected to validate and assess feasibility. A novel set of seven indicators was compiled initially, followed by the convening of a 36-member nationally representative expert panel. After three rounds of meticulous revisions, consensus was reached on 13 indicators across three domains. These finalized indicators underwent application in various hospital settings, demonstrating their initial validity and feasibility. The development of thirteen ultrasound quality indicators represents a significant milestone in evaluating ultrasound performance. These indicators empower hospitals to monitor changes in quality effectively, fostering efficient quality management practices.
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Affiliation(s)
- Aiping Zeng
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Yang Gu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Li Ma
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Xixi Tao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Luying Gao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Jianchu Li
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Hongyan Wang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
| | - Yuxin Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
- National Ultrasound Medical Quality Control Center, Beijing 100730, China
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Papp ZM, Szakács L, Hajivandi SS, Kalina I, Varga E, Kiss G, Solymos F, Takács I, Dank M, Dudás I, Szanka T, Dózsa CL, Rékassy B, Merkely B, Maurovich-Horvat P. Impact of a Targeted Project for Shortening of Imaging Diagnostic Waiting Time in Patients with Suspected Oncological Diseases in Hungary. Medicina (B Aires) 2023; 59:medicina59010153. [PMID: 36676777 PMCID: PMC9865166 DOI: 10.3390/medicina59010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Background and Objectives: Medical imaging is a key element in the clinical workup of patients with suspected oncological disease. In Hungary, due to the high number of patients, waiting lists for Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) were created some years ago. The Municipality of Budapest and Semmelweis University signed a cooperation agreement with an extra budget in 2020 (HBP: Healthy Budapest Program) to reduce the waiting lists for these patients. The aim of our study was to analyze the impact of the first experiences with the HBP. Material and Methods: The study database included all the CT/MRI examinations conducted at Semmelweis University with a referral diagnosis of suspected oncological disease within the first 13 months of the HBP (6804 cases). In our retrospective, two-armed, comparative clinical study, different components of the waiting times in the oncology diagnostics pathway were analyzed. Using propensity score matching, we compared the data of the HBP-funded patients (n = 450) to those of the patients with regular care provided by the National Health Insurance Fund (NHIF) (n = 450). Results: In the HBP-funded vs. the NHIF-funded patients, the time interval from the first suspicion of oncological disease to the request for imaging examinations was on average 15.2 days shorter (16.1 vs. 31.3 days), and the mean waiting time for the CT/MRI examination was reduced by 13.0 days (4.2 vs. 17.2 days, respectively). In addition, the imaging medical records were prepared on average 1.7 days faster for the HBP-funded patients than for the NHIF-funded patients (3.4 vs. 5.1 days, respectively). No further shortening of the different time intervals during the subsequent oncology diagnostic pathway (histological investigation and multidisciplinary team decision) or in the starting of specific oncological therapy (surgery, irradiation, and chemotherapy) was observed in the HBP-funded vs. the NHIF-funded patients. We identified a moderately strong negative correlation (r = -0.5736, p = 0.0350) between the CT/MR scans requested and the active COVID-19 case rates during the pandemic waves. Conclusion: The waiting lists for diagnostic CT/MR imaging can be effectively shortened with a targeted project, but a more comprehensive intervention is needed to shorten the time from the radiological diagnosis, through the decisions of the oncoteam, to the start of the oncological treatment.
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Affiliation(s)
- Zsombor Mátyás Papp
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary
| | - László Szakács
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Shayan-Salehi Hajivandi
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Ildikó Kalina
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Edit Varga
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Gergely Kiss
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Ferenc Solymos
- Directorate for Core IT Infrastructure and Critical Applications, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
| | - István Takács
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Magdolna Dank
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Ibolyka Dudás
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Tímea Szanka
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
| | - Csaba László Dózsa
- Municipality of Budapest, Városház utca 9-11, 1052 Budapest, Hungary
- Health Sciences Faculty, University of Miskolc, 3515 Miskolc-Egyetemváros, Hungary
| | - Balázs Rékassy
- Municipality of Budapest, Városház utca 9-11, 1052 Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Pál Maurovich-Horvat
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Korányi Sándor u. 2, 1083 Budapest, Hungary
- Correspondence: ; Tel.: +36-20-6632485
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Lin CY, Shih FC, Ho YH. Applying the Balanced Scorecard to Build Service Performance Measurements of Medical Institutions: An AHP-DEMATEL Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1022. [PMID: 36673778 PMCID: PMC9859192 DOI: 10.3390/ijerph20021022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The main purpose of this study is to explore the application of the balanced scorecard (BSC) to service performance measurements of medical institutions using the analytic hierarchy process (AHP) and decision making and trial evaluation laboratory (DEMATEL). According to the concept of BSC, a total of four evaluation dimensions and twenty-two indicators of medical service performance measurements were developed. To collect data, this study delivered expert questionnaires to medical-related professional supervisors, deans, and heads of medical institutions in Taiwan. By combining the AHP and DEMATEL, the priority and causality of service performance standards in medical institutions were obtained. The results of this study show that the customer dimension is the most important service performance measurement dimension for medical institutions. The seven key service performance measurement indicators that are most important for medical institutions, in order, are "complete and comfortable equipment", "competitiveness of the medical profession", "continuity of patient-to-hospital treatment", "classification of medical profession according to customers (VIP system)", "complete medical service", "complete salary, remuneration, and policy", and "medical incomes of institutions". In terms of causality, provided the complete services of medical institutions are improved, the continuity of patient-to-hospital treatment, the competitiveness of the medical profession, and the medical incomes of institutions would be influenced.
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Affiliation(s)
- Chieh-Yu Lin
- Department of International Business, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Fu-Chiang Shih
- Ph.D. Program in Business and Operations Management, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Yi-Hui Ho
- Department of International Business, Chang Jung Christian University, Tainan 71101, Taiwan
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Hamadi H, Zhao M, Haley DR, Xu J, Paryani S, Spaulding A. Observational Trends in Publicly Reported Quality Measures of Hospital Outpatient Quality Reporting Program, 2013-2019. J Ambul Care Manage 2022; 45:202-211. [PMID: 35612391 DOI: 10.1097/jac.0000000000000416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In 2011, the Centers for Medicare & Medicaid Services (CMS) implemented the Hospital Outpatient Quality Reporting Program to assess the quality of outpatient imaging efficiency (OIE). In this study, trends in hospital performance on these national hospital OIE measures a year after inception and public reporting were described. An observational trend analysis was conducted using 2013-2019 data from CMS 6 OIE measures. The trend analysis of metric scores indicates year-to-year variability in all 6 OIE variables. The reporting of these measures appears to have effectively improved the efficiency of most of the measures since the inception of the program.
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Affiliation(s)
- Hanadi Hamadi
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville (Drs Hamadi, Zhao, Haley, Xu, and Paryani); and Division of Health Care Policy and Research, Department of Health Sciences Research, Robert D. and Patricia E. Kern, Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida (Dr Spaulding)
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Lunn Y, Patel R, Sokphat TS, Bourn L, Fields K, Fitzgerald A, Sundaresan V, Thomas G, Korvink M, Gunn LH. Assessing Hospital Resource Utilization with Application to Imaging for Patients Diagnosed with Prostate Cancer. Healthcare (Basel) 2022; 10:healthcare10020248. [PMID: 35206863 PMCID: PMC8872431 DOI: 10.3390/healthcare10020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Resource utilization measures are typically modeled by relying on clinical characteristics. However, in some settings, those clinical markers are not available, and hospitals are unable to explore potential inefficiencies or resource misutilization. We propose a novel approach to exploring misutilization that solely relies on administrative data in the form of patient characteristics and competing resource utilization, with the latter being a novel addition. We demonstrate this approach in a 2019 patient cohort diagnosed with prostate cancer (n = 51,111) across 1056 U.S. healthcare facilities using Premier, Inc.’s (Charlotte, NC, USA) all payor databases. A multivariate logistic regression model was fitted using administrative information and competing resources utilization. A decision curve analysis informed by industry average standards of utilization allows for a definition of misutilization with regards to these industry standards. Odds ratios were extracted at the patient level to demonstrate differences in misutilization by patient characteristics, such as race; Black individuals experienced higher under-utilization compared to White individuals (p < 0.0001). Volume-adjusted Poisson rate regression models allow for the identification and ranking of facilities with large departures in utilization. The proposed approach is scalable and easily generalizable to other diseases and resources and can be complemented with clinical information from electronic health record information, when available.
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Affiliation(s)
- Yazmine Lunn
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
| | - Rudra Patel
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
| | - Timothy S. Sokphat
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Laura Bourn
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Khalil Fields
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Anna Fitzgerald
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Vandana Sundaresan
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Greeshma Thomas
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | | | - Laura H. Gunn
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA; (Y.L.); (R.P.); (T.S.S.); (L.B.); (K.F.); (A.F.); (V.S.)
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
- Faculty of Medicine, School of Public Health, Imperial College London, London W6 8RP, UK
- Correspondence:
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Nelson J, Ding A, Mann S, Parsons M, Samei E. Key Performance Indicators for Quality Imaging Practice: Why, What, and How. J Am Coll Radiol 2021; 19:4-12. [PMID: 34838511 DOI: 10.1016/j.jacr.2021.09.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/30/2021] [Indexed: 11/24/2022]
Abstract
A common trend across health care organizations is the development of key performance indicators (KPIs) for characterizing quality, identifying areas in need of change, and quantifying the impact of change. This article outlines a list of KPIs that can be used to quantify, target, and optimize value and value delivery in medical imaging practice. Of particular focus here is the aspect of practice that should be overseen and informed by the work of medical physicists, along the trajectory and expectations of a Medical Physics 3.0 model. The authors offer a framework for developing site-specific KPIs and several demonstrative clinical examples.
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Affiliation(s)
- Jeffrey Nelson
- Clinical Imaging Physics Group, Duke University Health System, Durham, North Carolina.
| | - Aiping Ding
- Clinical Imaging Physics Group, Duke University Health System, Durham, North Carolina
| | - Steven Mann
- Clinical Imaging Physics Group, Duke University Health System, Durham, North Carolina
| | - Michael Parsons
- Clinical Imaging Physics Group, Duke University Health System, Durham, North Carolina
| | - Ehsan Samei
- Clinical Imaging Physics Group, Departments of Radiology, Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University, Durham, North Carolina
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9
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Dick J, Darras KE, Lexa FJ, Denton E, Ehara S, Galloway H, Jankharia B, Kassing P, Kumamaru KK, Mildenberger P, Morozov S, Pyatigorskaya N, Song B, Sosna J, van Buchem M, Forster BB. An International Survey of Quality and Safety Programs in Radiology. Can Assoc Radiol J 2021; 72:135-141. [PMID: 32066249 DOI: 10.1177/0846537119899195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The aim of this study was to determine the status of radiology quality improvement programs in a variety of selected nations worldwide. METHODS A survey was developed by select members of the International Economics Committee of the American College of Radiology on quality programs and was distributed to committee members. Members responded on behalf of their country. The 51-question survey asked about 12 different quality initiatives which were grouped into 4 themes: departments, users, equipment, and outcomes. Respondents reported whether a designated type of quality initiative was used in their country and answered subsequent questions further characterizing it. RESULTS The response rate was 100% and represented Australia, Canada, China, England, France, Germany, India, Israel, Japan, the Netherlands, Russia, and the United States. The most frequently reported quality initiatives were imaging appropriateness (91.7%) and disease registries (91.7%), followed by key performance indicators (83.3%) and morbidity and mortality rounds (83.3%). Peer review, equipment accreditation, radiation dose monitoring, and structured reporting were reported by 75.0% of respondents, followed by 58.3% of respondents for quality audits and critical incident reporting. The least frequently reported initiatives included Lean/Kaizen exercises and physician performance assessments, implemented by 25.0% of respondents. CONCLUSION There is considerable diversity in the quality programs used throughout the world, despite some influence by national and international organizations, from whom further guidance could increase uniformity and optimize patient care in radiology.
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Affiliation(s)
- Jeremy Dick
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathryn E Darras
- University of British Columbia, Vancouver, British Columbia, Canada
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Frank J Lexa
- Department of Medical Imaging, 12216University of Arizona College of Medicine, Tucson, AZ, USA
- The Radiology Leadership Institute and Commission on Leadership and Practice Development, 72672American College of Radiology, Tucson, AZ, USA
| | - Erika Denton
- Norfolk & Norwich University Hospital, Norwich, Norfolk, United Kingdom
| | - Shigeru Ehara
- Department of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, Tohoku, Japan
| | | | | | - Pam Kassing
- 72672American College of Radiology, Reston, VA, USA
| | | | - Peter Mildenberger
- Department of Radiology, 9182University Medical Center Mainz, Mainz, Germany
| | | | - Nadya Pyatigorskaya
- Department of Neuroradiology, 27063Sorbonne University, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Bin Song
- West China Hospital, 12530Sichuan University, Chengdu, Sichuan, China
| | - Jacob Sosna
- Department of Radiology, 58884Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Marcus van Buchem
- Department of Radiology, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Bruce B Forster
- University of British Columbia, Vancouver, British Columbia, Canada
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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10
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Romeo P, Lo Re G, Cester R, Picone D, Di Mauro DM, Privitera G, Salerno S, Lagalla R, Midiri M. Radiologic team performance index: A new paradigm in KPI evaluating radiology examination volumes department performance: Results of Sicilian regional healthcare system survey. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2018.1472841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Placido Romeo
- ASP Messina, UOC Radiodiagnostica-Ospedale S. Vincenzo Taormina, Taormina, Italy
| | - Giuseppe Lo Re
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Roberto Cester
- Sicilia Sistemi Tecnologie srl – Gruppo Dedalus spa, Catania, Italy
| | - Dario Picone
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | | | - Giambattista Privitera
- AOU Policlinico-Vittorio Emanuele, UOC Radiodiagnostica Ospedale Vittorio Emanuele, Catania, Italy
| | - Sergio Salerno
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
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11
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Performance indicators for radiation protection management: suggestions from the European Society of Radiology. Insights Imaging 2020; 11:134. [PMID: 33296040 PMCID: PMC7726050 DOI: 10.1186/s13244-020-00923-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/30/2022] Open
Abstract
In 2013, the new European Basic Safety Standards Directive 2013/59/Euratom (BSS Directive), which defines the new legal framework for the use of ionising radiation in medical imaging and radiotherapy, was published. In 2014, the ESR EuroSafe Imaging Initiative was founded with a goal in mind “to support and strengthen medical radiation protection across Europe following a holistic, inclusive approach”. To support radiology departments in developing a programme of clinical audit, the ESR developed a Guide to Clinical Audit and an accompanying audit tool in 2017, with an expanded second edition released in 2019 and published under the name of Esperanto – ESR Guide to Clinical Audit in Radiology and the ESR Clinical Audit Tool, 2019. Audits represent specific aspects at a certain point in time, usually with retrospective evaluation of data. Key performance indicators (KPIs), on the other hand, are intended to enable continuous monitoring of relevant parameters, for example to provide warnings or a dashboard. KPIs, which can, for example, be recorded automatically and visualised in dashboards, are suitable for this purpose. This paper will discuss a selection of indicators covering different areas and include suggestions for their implementation.
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12
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Pathak S, van Rossen J, Vijlbrief O, Geerdink J, Seifert C, van Keulen M. Post-Structuring Radiology Reports of Breast Cancer Patients for Clinical Quality Assurance. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2020; 17:1883-1894. [PMID: 31059453 DOI: 10.1109/tcbb.2019.2914678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hospitals often set protocols based on well defined standards to maintain the quality of patient reports. To ensure that the clinicians conform to the protocols, quality assurance of these reports is needed. Patient reports are currently written in free-text format, which complicates the task of quality assurance. In this paper, we present a machine learning based natural language processing system for automatic quality assurance of radiology reports on breast cancer. This is achieved in three steps: we i) identify the top-level structure (headings) of the report, ii) classify the report content into the top-level headings, and iii) convert the free-text detailed findings in the report to a semi-structured format (post-structuring). Top level structure and content of report were predicted with an F1 score of 0.97 and 0.94, respectively, using Support Vector Machine (SVM) classifiers. For automatic structuring, our proposed hierarchical Conditional Random Field (CRF) outperformed the baseline CRF with an F1 score of 0.78 versus 0.71. The determined structure of the report is represented in semi-structured XML format of the free-text report, which helps to easily visualize the conformance of the findings to the protocols. This format also allows easy extraction of specific information for other purposes such as search, evaluation, and research.
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13
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Bhatia N, Trivedi H, Safdar N, Heilbrun ME. Artificial Intelligence in Quality Improvement: Reviewing Uses of Artificial Intelligence in Noninterpretative Processes from Clinical Decision Support to Education and Feedback. J Am Coll Radiol 2020; 17:1382-1387. [DOI: 10.1016/j.jacr.2020.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023]
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Gadeka DD, Esena RK. Barriers to Quality Care in Medical Imaging at a Teaching Hospital in Ghana: Staff Perspective. J Med Imaging Radiat Sci 2020; 51:425-435. [PMID: 32536512 DOI: 10.1016/j.jmir.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The goal of quality care is to ensure that the health care services provided to individuals and patient populations improve desired health outcomes. However, as medical imaging services increase in Ghana, empirical evidence show a low level of care. Despite this, there exists no study in the public domain on the barriers to quality care. This study, therefore, sought to identify barriers to quality care in medical imaging at a teaching hospital to provide evidence that will enable optimization of care and in improving the overall medical imaging care delivery system. METHODS This research was a descriptive, cross-sectional study using a mixed method approach based on the dimensions of quality of care of medical imaging services from medical imaging professionals' perspective: capacity and sustainability, timeliness, safety, equity, patient-centeredness, effective communication, and appropriateness of examination. QUANTITATIVE METHOD A 5-point Likert scale questionnaire was used. The study population included all medical imaging professionals (n = 47) at the imaging department of the hospital. However, a total of 36 agreed to participate in the study. Data were analyzed using Stata Version 13. Descriptive analyses were carried out. QUALITATIVE METHODS Purposive sampling strategy was applied to recruit 12 management team members and key staff with vast experience in medical imaging for the study. Data collection was done using a reflective in-depth interview guide. Data were analyzed using thematic analysis. QUANTITATIVE RESULTS The quantitative findings show more than half of the respondents (n = 23, 63.9%) currently play supervisory roles, 10 (27.8%) work more than 40 hours a week, a minority group (n = 7, 19.4%) examine more than 100 patients per week, and 21 (58.5%) reported quality improvement programs are not carried out. Overall, half (50.0%) of the respondents are unaware of the availability of standard operating procedures, 28 (77.7%) reported imaging machines are not always functional, 34 (94.5%) reported lack of adherence to equipment servicing practices, and 27 (75%) agreed that broken-down equipment are left for more than 3 months before being fixed. In addition, 26 respondents (80.5%) reported staff number is inadequate compared with the workload, whereas only 11 (30.6%) stated supervision by management is adequate. Furthermore, 12 respondents (33.4%) reported management seem interested in quality of care only after adverse event, only 5 (38.5%) of the radiologists stated they are able to meet image reporting deadlines for clients, and only 8 (22.2%) of the respondents reported the availability of means of communicating results to referring clinicians aside the normal report. QUALITATIVE RESULTS The qualitative findings show a lack of commitment to equipment servicing, frequent nonfunctionality of imaging machines, and an undue delay in repairs of broken-down machines. In addition, there exists inadequate human resource, inadequate supervision, a lack of quality improvement programs, and educational advancement opportunities for staff. The findings further show inadequacy of hospital gowns for patients, a lack of equity, and a poor organizational culture. In addition, the study identified a lack of means of communicating urgent imaging findings and a lack of promptness and timeliness to care from the consultant radiologists. CONCLUSION The low level of care of medical imaging services observed in Ghana is reflected in the large number of barriers to quality care identified in this study. Most barriers identified are in the capacity and sustainability, timeliness, and effective communication dimensions of quality of care. The findings have important implications for policy makers. Improvement in these areas will enable optimization of care and in improving the overall medical imaging care delivery system.
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Affiliation(s)
| | - Reuben K Esena
- School of Public Health, University of Ghana, Legon-Accra, Ghana
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Gadeka DD, Esena RK. Quality of Care of Medical Imaging Services at a Teaching Hospital in Ghana: Clients' Perspective. J Med Imaging Radiat Sci 2020; 51:154-164. [PMID: 32081678 DOI: 10.1016/j.jmir.2019.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Ministry of Health of Ghana is committed to delivering client-focused, quality-driven, and results-oriented medical imaging services. However, there remained a lack of empirical evidence regarding the state of the various dimensions of quality needed to establish evidence-based strategies to strengthen the medical imaging system. This study assessed the quality of care of medical imaging services from clients' perspective at a teaching hospital in order to inform policy. METHODS This research was a descriptive cross-sectional study using a mixed method approach based on the dimensions of quality of care in medical imaging: capacity and sustainability, timeliness, safety, equity, patient centeredness, and effective communication. QUANTITATIVE METHOD A 5-point Likert scale questionnaire was used. A total of 191 clients aged ≥18 years were recruited during medical imaging services at the imaging department of the hospital. A simple random sampling technique was used to select participants. Data were analyzed using Stata version 13. Descriptive analyses were carried out. QUALITATIVE METHODS Purposive sampling strategy was applied to recruit 12 in-depth interview participants. Reflective interview guide starting with demographic characteristics and followed by the dimensions of quality of care was used. Qualitative data were analyzed using thematic analysis. QUANTITATIVE RESULTS Overall, there is low quality of care 2.8 (standard deviation [SD] = 0.6). There is low quality with regards to timeliness 2.8 (SD = 0.4), patient centeredness 2.7 (SD = 0.7), equity 2.8 (SD = 0.2), effective communication 2.7 (SD = 0.7), and safety 2.5 (SD = 0.3). Quality of care in relation to capacity and sustainability is high 3.4 (0.6). Only 73 (38.2%) of the clients are currently satisfied with the quality of care, and only 39.8% will recommend others to access care at the imaging department. Only 66 (34.6%) of clients are of the view that staff behavior instills confidence. QUALITATIVE RESULTS The qualitative study shows a lack of equity, timeliness, and patient-centeredness in terms of care and privacy. There is a perceived lack of compliance with radiation protection protocols, and there exist wide communication gaps between clients and staff. Furthermore, there is a lack of capacity and sustainability in relation to the reliability and availability of functional equipment. There is, however, high appraisal from clients regarding the neatness and availability of staff. CONCLUSION A majority of clients are not satisfied with the quality of care of the medical imaging services. Improved interaction with clients, availability of functional equipment, and effective communication during the care process between the patients and the imaging professionals such as provision of timely information during the waiting period and explanation of procedure will help enhance the quality of care.
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Affiliation(s)
- Dominic Dormenyo Gadeka
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon-Accra, Ghana.
| | - Reuben K Esena
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon-Accra, Ghana
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Makanjee CR, Xu D, Sarswat D, Bergh AM. 'It is just part of life': patient perspectives and experiences of diagnostic imaging referrals. Aust J Prim Health 2020; 26:507-513. [PMID: 33211998 DOI: 10.1071/py20146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022]
Abstract
Referral for a medical imaging examination is an integral part of the medical consultation; however, not much is known about patients' experience of these referrals. The life-world experiences and perspectives of patients as 'persons' referred for an imaging investigation are explored through the lens of person-centred and whole-person care. Individual interviews were conducted with 22 patients referred for an imaging investigation. The findings were interpreted in terms of the journey of a patient; that is, the processes the patient undergoes as a person in the course of a referral for a diagnostic imaging investigation as part of the disease and its treatment. Participants' life and health journeys are described in terms of three themes: (1) events leading to an imaging examination; (2) the imaging referral experience embedded within the medical encounter; and (3) the integration of the findings of the imaging examination into their everyday life. Health practitioners should be mindful of the complexity of medical consultations that include a referral for an imaging investigation.
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Affiliation(s)
- Chandra Rekha Makanjee
- Department of Medical Radiation Science, University of Canberra, ACT 2617, Australia; and Corresponding author.
| | - Deon Xu
- Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | | | - Anne-Marie Bergh
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, South Africa
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Zhang L, Liu R, Jiang S, Luo G, Liu HC. Identification of Key Performance Indicators for Hospital Management Using an Extended Hesitant Linguistic DEMATEL Approach. Healthcare (Basel) 2019; 8:healthcare8010007. [PMID: 31881773 PMCID: PMC7151015 DOI: 10.3390/healthcare8010007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022] Open
Abstract
Performance analysis is of great significance to increase the operational efficiency of healthcare organizations. Healthcare performance is influenced by numerous indicators, but it is unrealistic for administrators to improve all of them due to the restriction of resources. To solve this problem, we integrated double hierarchy hesitant fuzzy linguistic term sets (DHHFLTSs) with the decision-making trial and evaluation laboratory (DEMATEL) and proposed a DHHFL– DEMATEL method to identify key performance indicators (KPIs) in healthcare management. For the developed approach, the judgments of experts on the inter-relationships among indicators were represented by DHHFLTSs, and a novel combination weighting approach was proposed to obtain experts’ weights in line with hesitant degree and consensus degree. Then, the normal DEMATEL method was extended and used for examining the cause and effect relationships between indicators; the technique for the order of preference by similarity to the ideal solution (TOPSIS) method was utilized to generate the ranking of performance indicators. Finally, the feasibility and effectiveness of the proposed DHHFL–DEMATEL approach were illustrated by a practical example in a rehabilitation hospital.
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Affiliation(s)
- Ling Zhang
- Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, NSW 2007, Australia;
- SILC Business School, Shanghai University, Shanghai 200444, China;
| | - Ran Liu
- School of Management, Shanghai University, Shanghai 200444, China;
| | - Shan Jiang
- School of Management, Shanghai University, Shanghai 200444, China;
- Correspondence:
| | - Gang Luo
- SILC Business School, Shanghai University, Shanghai 200444, China;
| | - Hu-Chen Liu
- College of Economics and Management, China Jiliang University, Hangzhou 310018, China;
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18
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Siewert B, Hochman M, Eisenberg RL, Swedeen S, Brook OR. Acing the Joint Commission Regulatory Visit: Running an Effective and Compliant Safety Program. Radiographics 2019; 38:1744-1760. [PMID: 30303792 DOI: 10.1148/rg.2018180134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ensuring the safety of patients and staff is a core effort of all health care organizations. Many regulatory agencies, from The Joint Commission to the Occupational Safety and Health Administration, provide policies and guidelines, with relevant metrics to be achieved. Data on safety can be obtained through a variety of mechanisms, including gemba walks, team discussion during safety huddles, audits, and individual employee entries in safety reporting systems. Data can be organized on a scorecard that provides an at-a-glance view of progress and early warning signs of practice drift. In this article, relevant policies are outlined, and instruction on how to achieve compliance with national patient safety goals and regulations that ensure staff safety and Joint Commission ever-readiness are described. Additional critical components of a safety program, such as department commitment, a just culture, and human factors engineering, are discussed. ©RSNA, 2018.
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Affiliation(s)
- Bettina Siewert
- From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02115
| | - Mary Hochman
- From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02115
| | - Ronald L Eisenberg
- From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02115
| | - Suzanne Swedeen
- From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02115
| | - Olga R Brook
- From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02115
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Chokshi FH, Flanders AE, Prevedello LM, Langlotz CP. Fostering a Healthy AI Ecosystem for Radiology: Conclusions of the 2018 RSNA Summit on AI in Radiology. Radiol Artif Intell 2019; 1:190021. [PMID: 33937789 PMCID: PMC8017423 DOI: 10.1148/ryai.2019190021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 05/03/2023]
Abstract
The 2018 RSNA Summit on AI in Radiology brought together a diverse group of stakeholders to identify and prioritize areas of need related to artificial intelligence in radiology. This article presents the proceedings of the summit with emphasis on RSNA's role in leading, organizing, and catalyzing change during this important time in radiology. © RSNA, 2019.
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Affiliation(s)
- Falgun H. Chokshi
- From the Departments of Radiology and Imaging Sciences and Biomedical Informatics, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (F.H.C.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.E.F.); Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio (L.M.P.); and Departments of Radiology and Biomedical Informatics, Stanford University School of Medicine, Stanford, Calif (C.P.L.)
| | - Adam E. Flanders
- From the Departments of Radiology and Imaging Sciences and Biomedical Informatics, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (F.H.C.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.E.F.); Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio (L.M.P.); and Departments of Radiology and Biomedical Informatics, Stanford University School of Medicine, Stanford, Calif (C.P.L.)
| | - Luciano M. Prevedello
- From the Departments of Radiology and Imaging Sciences and Biomedical Informatics, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (F.H.C.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.E.F.); Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio (L.M.P.); and Departments of Radiology and Biomedical Informatics, Stanford University School of Medicine, Stanford, Calif (C.P.L.)
| | - Curtis P. Langlotz
- From the Departments of Radiology and Imaging Sciences and Biomedical Informatics, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (F.H.C.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.E.F.); Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio (L.M.P.); and Departments of Radiology and Biomedical Informatics, Stanford University School of Medicine, Stanford, Calif (C.P.L.)
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20
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Ayvaci MUS, Alagoz O, Ahsen ME, Burnside ES. Preference-Sensitive Management of Post-Mammography Decisions in Breast Cancer Diagnosis. PRODUCTION AND OPERATIONS MANAGEMENT 2018; 27:2313-2338. [PMID: 31031555 PMCID: PMC6481963 DOI: 10.1111/poms.12897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Decision models representing the clinical situations where treatment options entail a significant risk of morbidity or mortality should consider the variations in risk preferences of individuals. In this study, we develop a stochastic modeling framework that optimizes risk-sensitive diagnostic decisions after a mammography exam. For a given patient, our objective is to find the utility maximizing diagnostic decisions where we define the utility over quality-adjusted survival duration. We use real data from a private mammography database to numerically solve our model for various utility functions. Our choice of utility functions for the numerical analysis is driven by actual patient behavior encountered in clinical practice. We find that invasive diagnostic procedures such as biopsies are more aggressively used than what the optimal risk-neutral policy would suggest, implying a far-sighted (or equivalently risk-seeking) behavior. When risk preferences are incorporated into the clinical practice, policy makers should bear in mind that a welfare loss in terms of survival duration is inevitable as evidenced by our structural and empirical results.
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Affiliation(s)
- Mehmet Ulvi Saygi Ayvaci
- Information Systems, Naveen Jindal School of Management, University of Texas at Dallas, 800 W Campbell Rd SM33, Richardson, Texas 75080, USA,
| | - Oguzhan Alagoz
- Department of Industrial and Systems Engineering, University of Wisconsin, Madison, Wisconsin 53705, USA,
| | - Mehmet Eren Ahsen
- Icahn School of Medicine at Mount Sinai, San Francisco, California 94108, USA,
| | - Elizabeth S Burnside
- Department of Radiology, University of Wisconsin, Madison, Wisconsin 53792, USA,
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21
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Kadom N, Zafar HM, Cook TS, Greene A, Durand DJ. Engaging Patients: Models for Patient- and Family-centered Care in Radiology. Radiographics 2018; 38:1866-1871. [DOI: 10.1148/rg.2018180018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Doss A. Value-based reimbursement in a person-centred health care environment: Implications for the Australian and New Zealand radiologist. J Med Imaging Radiat Oncol 2018; 62:803-805. [PMID: 30151993 DOI: 10.1111/1754-9485.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Arockia Doss
- Image Guided Therapy Clinic®, Nedlands, Western Australia, Australia.,Curtin Medical School, Perth, Western Australia, Australia
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23
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Kudla AU, Brook OR. Quality and Efficiency Improvement Tools for Every Radiologist. Acad Radiol 2018; 25:757-766. [PMID: 29572048 DOI: 10.1016/j.acra.2018.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 10/17/2022]
Abstract
In an era of value-based medicine, data-driven quality improvement is more important than ever to ensure safe and efficient imaging services. Familiarity with high-value tools enables all radiologists to successfully engage in quality and efficiency improvement. In this article, we review the model for improvement, strategies for measurement, and common practical tools with real-life examples that include Run chart, Control chart (Shewhart chart), Fishbone (Cause-and-Effect or Ishikawa) diagram, Pareto chart, 5 Whys, and Root Cause Analysis.
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24
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Evidence-Based Reporting: A Method to Optimize Prostate MRI Communications With Referring Physicians. AJR Am J Roentgenol 2018; 210:108-112. [DOI: 10.2214/ajr.17.18260] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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25
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Wang K, Zwart C, Wellnitz C, Wu T, Li J. Integration of multiple health information systems for quality improvement of radiologic care. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/24725579.2017.1329241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kun Wang
- Industrial Engineering, School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Christine Zwart
- Department of Radiology, May Clinic in Arizona, Scottsdale, AZ, USA
| | - Clinton Wellnitz
- Department of Radiology, May Clinic in Arizona, Scottsdale, AZ, USA
| | - Teresa Wu
- Industrial Engineering, School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Jing Li
- Industrial Engineering, School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
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Itri JN, Mithqal A, Krishnaraj A. Funds Flow in the Era of Value-Based Health Care. J Am Coll Radiol 2017; 14:818-824. [DOI: 10.1016/j.jacr.2017.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/02/2017] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
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27
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White BA, Yun BJ, Lev MH, Raja AS. Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department. West J Emerg Med 2017; 18:410-418. [PMID: 28435492 PMCID: PMC5391891 DOI: 10.5811/westjem.2016.12.32457] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. METHODS This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013-3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. RESULTS Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5-7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7-8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year following the intervention (7.4 minutes, 95% CI [4.8-9.9]; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in ED radiology processes. CONCLUSION In this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource use.
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Affiliation(s)
- Benjamin A. White
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Brian J. Yun
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts
| | - Michael H. Lev
- Massachusetts General Hospital, Department of Radiology, Boston, Massachusetts
| | - Ali S. Raja
- Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts
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Walker EA, Petscavage-Thomas JM, Fotos JS, Bruno MA. Quality metrics currently used in academic radiology departments: results of the QUALMET survey. Br J Radiol 2017; 90:20160827. [PMID: 28118038 DOI: 10.1259/bjr.20160827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA. METHODS The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments. RESULTS There was a 34.8% institutional response rate. We found that most academic departments of radiology commonly utilize metrics of hand hygiene, report turn around time (RTAT), relative value unit (RVU) productivity, patient satisfaction and participation in peer review. RTAT targets were found to vary widely. The implementation of radiology peer review and the variety of ways in which peer review results are used within academic radiology departments, the use of clinical decision support tools and requirements for radiologist participation in Maintenance of Certification also varied. Policies for hand hygiene and critical results communication were very similar across all institutions reporting, and most departments utilized some form of missed case/difficult case conference as part of their quality and safety programme, as well as some form of periodic radiologist performance reviews. CONCLUSION Results of the QUALMET survey suggest many similarities in tracking and utilization of the selected quality and productivity metrics included in our survey. Use of quality indicators is not a fully standardized process among academic radiology departments. Advances in knowledge: This article examines the current quality and productivity metrics in academic radiology.
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Affiliation(s)
- Eric A Walker
- 1 Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.,2 Department of Radiology and Nuclear Medicine, Uniformed University of the Health Sciences, Bethesda, MD, USA
| | | | - Joseph S Fotos
- 1 Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Michael A Bruno
- 1 Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Abstract
OBJECTIVE The purpose of this article is to introduce the reader to basic concepts of quality and safety in radiology. CONCLUSION Concepts are introduced that are keys to identifying, understanding, and utilizing certain quality tools with the aim of making process improvements. Challenges, opportunities, and change drivers can be mapped from the radiology quality perspective. Best practices, informatics, and benchmarks can profoundly affect the outcome of the quality improvement initiative we all aim to achieve.
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Karami M. Development of key performance indicators for academic radiology departments. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2016. [DOI: 10.1080/20479700.2016.1268350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mahtab Karami
- Department of Health Information Technology and Management, Health Information Management Research Center (HIMRC), School of Allied-Medical sciences, Kashan University of Medical Sciences, Kashan, Iran
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Karami M, Safdari R. From Information Management to Information Visualization: Development of Radiology Dashboards. Appl Clin Inform 2016; 7:308-29. [PMID: 27437043 DOI: 10.4338/aci-2015-08-ra-0104] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/26/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The development and implementation of a dashboard of medical imaging department (MID) performance indicators. METHOD Several articles discussing performance measures of imaging departments were searched for this study. All the related measures were extracted. Then, a panel of imaging experts were asked to rate these measures with an open ended question to seek further potential indicators. A second round was performed to confirm the performance rating. The indicators and their ratings were then reviewed by an executive panel. Based on the final panel's rating, a list of indicators to be used was developed. A team of information technology consultants were asked to determine a set of user interface requirements for the building of the dashboard. In the first round, based on the panel's rating, a list of main features or requirements to be used was determined. Next, Qlikview was utilized to implement the dashboard to visualize a set of selected KPI metrics. Finally, an evaluation of the dashboard was performed. RESULTS 92 MID indicators were identified. On top of this, 53 main user interface requirements to build of the prototype of dashboard were determined. Then, the project team successfully implemented a prototype of radiology management dashboards into study site. The visual display that was designed was rated highly by users. CONCLUSION To develop a dashboard, management of information is essential. It is recommended that a quality map be designed for the MID. It can be used to specify the sequence of activities, their related indicators and required data for calculating these indicators. To achieve both an effective dashboard and a comprehensive view of operations, it is necessary to design a data warehouse for gathering data from a variety of systems. Utilizing interoperability standards for exchanging data among different systems can be also effective in this regard.
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Affiliation(s)
- Mahtab Karami
- Health Information Management Research Center (HIMRC), department of health information technology and management, School of Allied-Medical sciences, Kashan University of Medical Sciences , Kashan, Iran
| | - Reza Safdari
- Department of health information management, School of Allied-Medical sciences, Tehran University of Medical Sciences , Tehran, Iran
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Harvey HB, Hassanzadeh E, Aran S, Rosenthal DI, Thrall JH, Abujudeh HH. Key Performance Indicators in Radiology: You Can’t Manage What You Can’t Measure. Curr Probl Diagn Radiol 2016; 45:115-21. [DOI: 10.1067/j.cpradiol.2015.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/21/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022]
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Kadom N, Nagy P. Data Drives Quality Improvement. J Am Coll Radiol 2015; 12:1296-7. [DOI: 10.1016/j.jacr.2015.09.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 09/10/2015] [Indexed: 10/22/2022]
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Herold CJ, Lewin JS, Wibmer AG, Thrall JH, Krestin GP, Dixon AK, Schoenberg SO, Geckle RJ, Muellner A, Hricak H. Imaging in the Age of Precision Medicine: Summary of the Proceedings of the 10th Biannual Symposium of the International Society for Strategic Studies in Radiology. Radiology 2015; 279:226-38. [PMID: 26465058 DOI: 10.1148/radiol.2015150709] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
During the past decade, with its breakthroughs in systems biology, precision medicine (PM) has emerged as a novel health-care paradigm. Challenging reductionism and broad-based approaches in medicine, PM is an approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. It involves integrating information from multiple sources in a holistic manner to achieve a definitive diagnosis, focused treatment, and adequate response assessment. Biomedical imaging and imaging-guided interventions, which provide multiparametric morphologic and functional information and enable focused, minimally invasive treatments, are key elements in the infrastructure needed for PM. The emerging discipline of radiogenomics, which links genotypic information to phenotypic disease manifestations at imaging, should also greatly contribute to patient-tailored care. Because of the growing volume and complexity of imaging data, decision-support algorithms will be required to help physicians apply the most essential patient data for optimal management. These innovations will challenge traditional concepts of health care and business models. Reimbursement policies and quality assurance measures will have to be reconsidered and adapted. In their 10th biannual symposium, which was held in August 2013, the members of the International Society for Strategic Studies in Radiology discussed the opportunities and challenges arising for the imaging community with the transition to PM. This article summarizes the discussions and central messages of the symposium.
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Affiliation(s)
- Christian J Herold
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Jonathan S Lewin
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Andreas G Wibmer
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - James H Thrall
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Gabriel P Krestin
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Adrian K Dixon
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Stefan O Schoenberg
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Rena J Geckle
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Ada Muellner
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
| | - Hedvig Hricak
- From the Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (C.J.H., A.G.W.); Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md (J.S.L., R.J.G.); Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands (G.P.K.); Department of Radiology, University of Cambridge, Cambridge, England (A.K.D.); Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (S.O.S.); and Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065 (A.M., H.H.)
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Kelly AM, Cronin P. Practical Approaches to Quality Improvement for Radiologists. Radiographics 2015; 35:1630-42. [DOI: 10.1148/rg.2015150057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zhang L, Domröse S, Mahnken A. Reconciling quality and cost: A case study in interventional radiology. Eur Radiol 2015; 25:2898-904. [PMID: 26002125 DOI: 10.1007/s00330-015-3702-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 01/16/2015] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To provide a method to calculate delay cost and examine the relationship between quality and total cost. METHODS The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. RESULTS Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 € to 294 €, and marginal delay costs from approximately 2000 € to 500 €, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 €. The yearly delay cost saved was approximately 150,000 €. With increased revenue of 10,000 € in project phase 2, the yearly total cost saved was approximately 290,000 €. Optimal daily capacity of 4.2 procedures was determined. CONCLUSIONS An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. KEY POINTS • Improving quality in terms of safety, outcome, efficiency and timeliness reduces cost. • Mismatch of demand and capacity is detrimental to quality and cost. • Full system utilization with random demand results in long waiting periods and increased cost.
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Affiliation(s)
- Li Zhang
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen and Marburg, Philipps University of Marburg, Baldinger Strasse, 35033, Marburg, Germany,
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Sarwar A, Boland G, Monks A, Kruskal JB. Metrics for Radiologists in the Era of Value-based Health Care Delivery. Radiographics 2015; 35:866-76. [DOI: 10.1148/rg.2015140221] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kruskal JB, Sarwar A. An Introduction to Basic Quality Metrics for Practicing Radiologists. J Am Coll Radiol 2015; 12:330-2. [DOI: 10.1016/j.jacr.2014.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 12/16/2014] [Accepted: 12/18/2014] [Indexed: 10/23/2022]
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Olisemeke B, Chen YF, Hemming K, Girling A. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review. J Digit Imaging 2014; 27:751-78. [PMID: 24888629 PMCID: PMC4391068 DOI: 10.1007/s10278-014-9706-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.
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Affiliation(s)
- B Olisemeke
- Radiology Department, Heart of England NHS Foundation Trust, Birmingham, UK,
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Karami M. A design protocol to develop radiology dashboards. Acta Inform Med 2014; 22:341-6. [PMID: 25568585 PMCID: PMC4272837 DOI: 10.5455/aim.2014.22.341-346] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/12/2014] [Indexed: 11/04/2022] Open
Abstract
Aim: The main objective of this descriptive and development research was to introduce a design protocol to develop radiology dashboards. Material and methods: The first step was to determine key performance indicators for radiology department. The second step was to determine required infrastructure for implementation of radiology dashboards. Infrastructure was extracted from both data and technology perspectives. The third step was to determine main features of the radiology dashboards. The fourth step was to determine the key criteria for evaluating the dashboards. In all these steps, non-probability sampling methods including convenience and purposive were employed and sample size determined based on a persuasion model. Results: Results showed that there are 92 KPIs, 10 main features for designing dashboards and 53 key criteria for dashboards evaluation. As well as, a Prototype of radiology management dashboards in four aspects including services, clients, personnel and cost-income were implemented and evaluated. Applying such dashboards could help managers to enhance performance, productivity and quality of services in radiology department.
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Affiliation(s)
- Mahtab Karami
- Department of Health Information Technology and Management. School of Allied Medical Sciences. Kashan University of Medical Sciences, Kashan, Iran
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Ngan TL, Wong ETH, Ng KLS, Jeor PKS, Law MYY, Lo GG. Key Performance Indicators for Comparing the Performance of Portable Radiography: Direct Digital Radiography versus Conventional Machine Computed Radiography-A Study in a Nonacute Hospital. J Med Imaging Radiat Sci 2014; 45:105-114. [PMID: 31051940 DOI: 10.1016/j.jmir.2013.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/08/2013] [Accepted: 08/30/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Portable radiography traditionally has been performed with a conventional portable x-ray unit with computed radiography (CR) system (conventional-CR combo), and off-site processing of the exposed CR cassettes was time-consuming. The direct digital radiography (DDR) portable x-ray system, with the digital image immediately available for review and wireless transmission as the key merits, is newly installed for portable radiography. Thus, the work flow of portable radiography is changed. This study was performed to quantitatively investigate the performance of portable radiography using the DDR portable x-ray system and conventional-CR combo in terms of efficiency and work flow enhancement. METHODS One hundred ninety portable x-ray examinations were timed for each procedural step using conventional-CR combo (n=97) and the DDR portable x-ray system. The following key performance indicators were designed for measuring the performance of portable radiography quantitatively: "examination duration," "time for image becoming available in PACS," "postacquisition processing time," and "manpower deployment time." RESULTS Productivity was raised by 96% using the DDR portable x-ray system. "Examination duration" using the DDR portable system was significantly faster (P < .0001), with a mean calculated time of 13.4 ± 7.6 minutes for the DDR portable system and 25.2 ± 10.9 minutes for conventional-CR combo. The "time for image becoming available in PACS" was significantly shorter than that of conventional-CR combo (P < .0001), with a mean time of 6.8 ± 2.6 minutes for the DDR portable system and 19.2 ± 9.7 minutes for conventional-CR combo. The "postacquisition processing time" was measured with slight differences, with a mean time of 2.2 ± 1.1 minutes for the DDR portable system and 1.9 ± 1.0 minutes for conventional-CR combo (P = .1064). Because more portable x-ray examinations could be performed when using the DDR portable x-ray system in each round of service, the mean "manpower deployment time" when using the DDR portable x-ray system was longer (ie, 82.6 ± 46.8 minutes for the DDR portable system and 24.5 ± 11.9 minutes for conventional-CR combo). CONCLUSIONS By using the new DDR portable x-ray system with work flow changes, the performance of portable radiography was improved in efficiency and work flow was enhanced. Furthermore, the four defined key performance indicators in this study may help provide a framework for measuring the performance of portable radiography in other institutions.
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Affiliation(s)
- Tsz-Lung Ngan
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China.
| | - Edward Ting-Hei Wong
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Kris Lap-Shun Ng
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Patrick Kwok-Shing Jeor
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Maria Yuen-Yee Law
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Gladys Goh Lo
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
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Patient Safety in Radiology. PATIENT SAFETY 2014. [DOI: 10.1007/978-1-4614-7419-7_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Interrater agreement in the evaluation of discrepant imaging findings with the Radpeer system. AJR Am J Roentgenol 2013; 199:1320-7. [PMID: 23169725 DOI: 10.2214/ajr.12.8972] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The Radpeer system is central to the quality assurance process in many radiology practices. Previous studies have shown poor agreement between physicians in the evaluation of their peers. The purpose of this study was to assess the reliability of the Radpeer scoring system. MATERIALS AND METHODS A sample of 25 discrepant cases was extracted from our quality assurance database. Images were made anonymous; associated reports and identities of interpreting radiologists were removed. Indications for the studies and descriptions of the discrepancies were provided. Twenty-one subspecialist attending radiologists rated the cases using the Radpeer scoring system. Multirater kappa statistics were used to assess interrater agreement, both with the standard scoring system and with dichotomized scores to reflect the practice of further review for cases rated 3 and 4. Subgroup analyses were conducted to assess subspecialist evaluation of cases. RESULTS Interrater agreement was slight to fair compared with that expected by chance. For the group of 21 raters, the kappa values were 0.11 (95% CI, 0.06-0.16) with the standard scoring system and 0.20 (95% CI, 0.13-0.27) with dichotomized scores. There was disagreement about whether a discrepancy had occurred in 20 cases. Subgroup analyses did not reveal significant differences in the degree of interrater agreement. CONCLUSION The identification of discrepant interpretations is valuable for the education of individual radiologists and for larger-scale quality assurance and quality improvement efforts. Our results show that a ratings-based peer review system is unreliable and subjective for the evaluation of discrepant interpretations. Resources should be devoted to developing more robust and objective assessment procedures, particularly those with clear quality improvement goals.
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Allen V. Home improvement. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2013; 35:11-6. [PMID: 23343790 DOI: 10.1016/s1701-2163(15)31039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Allen V. Rénovations. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2013. [DOI: 10.1016/s1701-2163(15)31040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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FRIGO NV, ROTANOV SV, KUBANOV AA, SKOPETSKAYA TV, MANUKIYAN TYE, NEGASHEVA YES. Indices of work quality for specialized medical institutions of the dermatovenerology profile aimed at syphilis diagnostics (a review of literature). VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors present the results of a study of literature sources for such indices as assessment of the efficacy and quality of medical services in medical care institutions based on quantitative parameters being quality indices. The authors demonstrate that indices for assessing the quality of work at medical institutions can involve information about materials, technical and other resources and personnel available at institutions, state statistics accounting forms, data from information and analytical systems and patient registers as well as additional indices developed by experts. Incidence indices are currently the key indicator for assessing the work quality of institutions dealing with syphilis diagnostics. No indicators and criteria for assessing the quality of laboratory assistance rendered to syphilitic patients have been developed yet.
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Experience With a Practice Quality Improvement System in a University Radiology Department. J Am Coll Radiol 2012; 9:814-9. [DOI: 10.1016/j.jacr.2012.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/10/2012] [Indexed: 11/18/2022]
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Kawooya MG, Pariyo G, Malwadde EK, Byanyima R, Kisembo H. Assessing the performance of medical personnel involved in the diagnostic imaging processes in mulago hospital, kampala, Uganda. J Clin Imaging Sci 2012; 2:61. [PMID: 23230543 PMCID: PMC3515952 DOI: 10.4103/2156-7514.102060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 07/29/2012] [Indexed: 11/17/2022] Open
Abstract
Objectives: Uganda, has limited health resources and improving performance of personnel involved in imaging is necessary for efficiency. The objectives of the study were to develop and pilot imaging user performance indices, document non-tangible aspects of performance, and propose ways of improving performance. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in Mulago National Referral Hospital over a period of 3 years from 2005 to 2008. The qualitative study used in-depth interviews, focus group discussions, and self-administered questionnaires, to explore clinicians’ and radiologists’ performancerelated views. Results: The study came up with following indices: appropriate service utilization (ASU), appropriateness of clinician's nonimaging decisions (ANID), and clinical utilization of imaging results (CUI). The ASU, ANID, and CUI were: 94%, 80%, and 97%, respectively. The clinician's requisitioning validity was high (positive likelihood ratio of 10.6) contrasting with a poor validity for detecting those patients not needing imaging (negative likelihood ratio of 0.16). Some requisitions were inappropriate and some requisition and reports lacked detail, clarity, and precision. Conclusion: Clinicians perform well at imaging requisition-decisions but there are issues in imaging requisitioning and reporting that need to be addressed to improve performance.
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Affiliation(s)
- Michael G Kawooya
- Ernest Cook Ultrasound Research and Education Institute (ECUREI), Kampala, Uganda
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Kawooya MG, Pariyo G, Malwadde EK, Byanyima R, Kisembo H. Assessing the performance of imaging health systems in five selected hospitals in Uganda. J Clin Imaging Sci 2012; 2:12. [PMID: 22530183 PMCID: PMC3328977 DOI: 10.4103/2156-7514.94225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 02/20/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The first objective of the study was to develop an index termed as the 'Imaging Coverage' (IC), for measuring the performance of the imaging health systems. This index together with the Hospital-Based Utilization (HBU) would then be calculated for five Ugandan hospitals. Second, was to relate the financial resources and existing health policy to the performance of the imaging systems. MATERIALS AND METHODS This was a cross-sectional survey employing the triangulation methodology, conducted in Mulago National Referral Hospital. The qualitative study used cluster sampling, in-depth interviews, focus group discussions, and self-administered questionnaires to explore the non-measurable aspects of the imaging systems' performances. RESULTS The IC developed and tested as an index for the imaging system's performance was 36%. General X-rays had the best IC followed by ultrasound. The Hospital-Based Utilization for the five selected hospitals was 186 per thousand and was the highest for general radiography followed by ultrasound. CONCLUSION The IC for the five selected hospitals was 36% and the HBU was 186 per thousand, reflecting low performance levels, largely attributable to inadequate funding. There were shortfalls in imaging requisitions and inefficiencies in the imaging systems, financing, and health policy. Although the proportion of inappropriate imaging was small, reducing this inappropriateness even further would lead to a significant total saving, which could be channeled into investigating more patients. Financial resources stood out as the major limitation in attaining the desired performance and there is a need to increase budget funding so as to improve the performance of the imaging health systems.
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Affiliation(s)
- Michael G. Kawooya
- Department of Radiology, Ernest Cook Ultrasound Research and Education Institute, Kampala, Uganda
| | - George Pariyo
- Health Services Research, School of Public Health, Kampala, Uganda
| | - Elsie Kiguli Malwadde
- Department of Radiology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rosemary Byanyima
- Department of Radiology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Harriet Kisembo
- Department of Radiology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Kruskal JB, Eisenberg R, Sosna J, Yam CS, Kruskal JD, Boiselle PM. Quality initiatives: Quality improvement in radiology: basic principles and tools required to achieve success. Radiographics 2012; 31:1499-509. [PMID: 21997978 DOI: 10.1148/rg.316115501] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
All imaging departments are expected to establish and maintain effective quality, safety, and performance improvement programs. Essential components of such programs include adherence to the basic principles of quality management and appropriate utilization of quality tools. The initial step is the gathering of relevant information, followed by the collection and analysis of quality and performance data; analysis and ranking of causes that likely contributed to a process failure, error, or adverse event; and prioritization and local implementation of solutions, with careful monitoring of newly implemented processes and wider dissemination of the tools when a process proves to be successful. Quality improvement requires a careful, dedicated, and continuously planned effort by a number of skilled and committed team members, with the goal being to do the right thing in a timely fashion in every case. This process can be sustained by offering rewards and celebrating successes, with all lessons learned disseminated throughout the department or organization.
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Affiliation(s)
- Jonathan B Kruskal
- Department of Radiology, Beth Israel Deaconess Medical Center, 1 Deaconess Rd, Boston, MA 02215, USA.
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