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Ernst BP, Dörsching C, Bozzato A, Gabrielpillai J, Becker S, Froelich MF, Kramer B, Sproll C, Schapher M, Goncalves M, Mansour N, Hofauer B, Sommer WH, von Scotti F, Weimer JM, Künzel J. Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability. Ultrasound Int Open 2023; 9:E26-E32. [PMID: 37808417 PMCID: PMC10556873 DOI: 10.1055/a-2173-3966] [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: 07/30/2023] [Accepted: 08/14/2023] [Indexed: 10/10/2023] Open
Abstract
Purpose Ultrasound examinations are often criticized for having higher examiner dependency compared to other imaging techniques. Compared to free-text reporting, structured reporting (SR) of head and neck sonography (HNS) achieves superior time efficiency as well as report quality. However, there are no findings concerning the influence of SR on the interrater reliability (IRR) of HNS. Materials and Methods Typical pathologies (n=4) in HNS were documented by video/images by two certified head and neck ultrasound instructors. Consequently, structured reports of these videos/images were created by n=9 senior physicians at departments of otolaryngology or maxillofacial surgery with DEGUM instructors on staff. Reports (n=36) were evaluated regarding overall completeness and IRR. Additionally, user satisfaction was assessed by a visual analog scale (VAS). Results SR yielded very high report completeness (91.8%) in all four cases with a substantial IRR (Fleiss' κ 0.73). Interrater agreement was high at 87.2% with very good user satisfaction (VAS 8.6). Conclusion SR has the potential to ensure high-quality examination reports with substantial comparability and very high user satisfaction. Furthermore, big data collection and analysis are facilitated by SR. Therefore, process quality, workflow, and scientific output are potentially enhanced by SR.
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Affiliation(s)
| | - Carla Dörsching
- Department of Otorhinolaryngology, University Medical Center Bonn,
Bonn, Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head & Neck Surgery,
Saarland University Hospital and Saarland University Faculty of Medicine,
Homburg, Germany
| | - Jennis Gabrielpillai
- Department of Otorhinolaryngology, University Medical Center Bonn,
Bonn, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University of
Tübingen Medical Center, Tuebingen, Germany
| | - Matthias Frank Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre
Mannheim, Mannheim, Germany
| | - Benedikt Kramer
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Medical Centre Mannheim, Mannheim, Germany
| | - Christoph Sproll
- Department of Oral and Maxillofacial Surgery, Medical Faculty and
University Hospital Düsseldorf, Duesseldorf, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus
Medical University, Nuremberg, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, RWTH
Aachen University Hospital, Aachen, Germany
| | - Naglaa Mansour
- Department of Otorhinolaryngology, University Medical Center Freiburg,
Freiburg, Germany
| | - Benedikt Hofauer
- Department of Otorhinolaryngology, Head and Neck Surgery, Technical
University of Munich Hospital Rechts der Isar, Munich, Germany
| | - Wieland H Sommer
- Department of Radiology, LMU University Hospital, Munich,
Germany
| | - Felix von Scotti
- Ultrasound Division, Otorhinolaryngology Center Münsterland,
Münster, Germany
| | - Johannes Matthias Weimer
- Rudolf-Frey Teaching Department, University Medical Center of the
Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Universitätsklinikum
Regensburg, Regensburg, Germany
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Johannesen DTS, Lindøe PH, Wiig S. Certification as support for resilience? Behind the curtains of a certification body - a qualitative study. BMC Health Serv Res 2020; 20:730. [PMID: 32771012 PMCID: PMC7414657 DOI: 10.1186/s12913-020-05608-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Certification in healthcare often involves independent private sector bodies performing legally required or voluntary external assurance activities. These certification practices are embedded in international standards founded in traditional beliefs about rational and predictable processes for quality and safety improvement. Certification can affect organizational and cultural changes, support collaboration and encourage improvement that may be conducive to resilient performance. This study explores whether ISO 9001 quality management system certification can support resilience in healthcare, by looking at characteristics in the objectives, methods, and practice of certification from a certification body's perspective. METHODS One of Norway's four certification bodies in healthcare was studied, using an explorative embedded single-case design. The study relies on document analysis of the international standards and associated guidances for the performance of certification bodies and thematic analyses of data from 60 h of observations of auditors in three certification processes and nine qualitative interviews with managers and personnel from the certification body. Results from the analyses were compared to identify discrepancies between the written and perceived certification approach and practice. RESULTS Standards and guidances for certification embed an elasticity between formal and consistent assessments of nonconformities in organizations and emphasize holistic approaches that brings added value. Auditors were then left with the latitude to navigate their auditing strategy during interaction with the auditees. Members of the certification body perceived and practiced a holistic and flexible auditing approach using opportunities to share knowledge, empower and make guidance for improvement. CONCLUSIONS ISO certification expects structures and systems to ensure consistent and objective certification processes. At the same time, it embodies a latitude to adopt flexible and context-specific certification approaches, as demonstrated by a certification body in this study, to give added value to the certified organizations. Such an ISO 9001 certification approach may support resilient performance in healthcare by nurturing the potential to respond and learn. These results are important for further development of methods that certification bodies use in the auditing encounter.
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Affiliation(s)
- Dag Tomas Sagen Johannesen
- Department of Media and Social Sciences, The Faculty of Social Sciences, University of Stavanger, 4036, Stavanger, Norway. .,Department of Health and Nursing Science, University of Agder, 4604, Kristiansand, Norway. .,SHARE-Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
| | - Preben Hempel Lindøe
- Department of Safety, Economics and Planning, Faculty of Science and Technology, University of Stavanger, 4036, Stavanger, Norway
| | - Siri Wiig
- SHARE-Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
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