High Quality Above All Else in Your Practice, Part 1 of 2

March 25, 2011

We’ve considered how the competitive nature of the marketplace has influenced practice behavior, or should. Chiefly, what sets you apart? That is, what value do you add? And how do you make sure your practice is of high quality?

We’ve considered how the competitive nature of the marketplace has influenced practice behavior, or should. Chiefly, what sets you apart? That is, what value do you add?

While the value added may be different for different groups and for different radiologists, we all have one central tenet: provide quality imaging. Importantly, quality comes in a variety of forms and may be different for patients, referring physicians, and technical-side providers (your hospital or imaging center owner).

So how do you make sure your practice is of high quality? What are the elements of quality?

Focus on improving accuracy. The first, most obvious and perhaps most important, quality area is accuracy and consistency of image interpretation. We are all familiar with the ACR’s system for peer review and that system or one like it should be employed with rigor.

In our institution we use independent software that is integrated into the PACS for this. That has made tracking of the data far easier and has increased the number of studies subjected to peer review. Such a system satisfies two goals. First, we strive to meet ACR recommendations, JCAHO requirements, and hospital requirements. The system allows us to satisfy those needs and quantify them. Importantly, satisfaction of those goals should not be seen as onerous.

How is this value added? Stress to all your MDs, the hospital, and especially younger group members that this is a great way to demonstrate the seriousness with which your group treats its job. You should be happy to tout the regular use of the system. Be forthright with the data and not shy of it. Remind everyone that even though radiology can be one of the most humbling specialties, all of us grow from criticism.

The second goal achieved is communication of oversights and errors, and rapid correction or rectification. Where in the past we might have spent time tracking down colleagues or even have forgotten to communicate the need for such corrections, we now can do this immediately. Your clinicians will thank you for timely responses and corrections; and the hospital will be able to see your rapid response as value.

Hold regular “M and M.” Many radiology groups are not used to such conferences, which we all attended in surgery and medicine as students. Make them friendly learning opportunities - not finger pointing sessions. Pick cases that make a point about unique findings or commonplace errors that can be improved.

We have begun to hold such conferences quarterly. Mandate attendance and produce minutes for your hospital or imaging partners. Conferences like this help the hospital show competence of staff. Moreover, they will understand your group’s overriding interest in quality.

Look for trends. Ultimately, your value added is value to the patient. If there are systematic problems occurring, consider forming a working group to analyze them. You may want to enlist nursing or administrative staff support in data gathering. Work toward a recommendation or set of recommendations that might improve this. Working with the hospital on such problems emphasizes that you are a partner to them, and that patient care is primary.