A Commitment to Quality and Safety in Imaging

Richard J. Friedland, MD, FACR, President of Hudson Valley Radiologists (HVR), contributed this piece.

The field of radiology continues to evolve, driven by groundbreaking advancements in artificial intelligence (AI), technology and more. As we usher in a new era of AI, workflow optimization and advanced imaging techniques, we must continue to provide the highest standards of quality and safety to safeguard our patients.

My practice has been involved with various quality and safety efforts for some time. I’ve sent my staff to the American College of Radiology^® (ACR^®) Quality, Safety + Informatics Conference for several years. When the ACR application to participate in the first Learning Network cohort arrived, my staff asked if we could participate. Getting involved in the Learning Network was the next step in developing our quality and safety program, allowing us to involve more staff than the core individuals who usually participate in our internal program.

As there is little published research on strategies to improve the quality of follow-up recommendations, we used the ACR ImPower framework to develop a highly reliable solution by leveraging technology that works in real-time with the radiologist workflow. Undergoing a current state analysis and gaining a deeper understanding of the root causes of missed follow-ups was integral to our success. The ImPower program worked with us to delve deeply into problems while keeping us agile enough to iterate many solutions that would ultimately solve these problems for both our radiologists and our patients. The program was helpful because it used qualitative and quantitative methodologies as part of the problem-solving strategy. The ImPower program was not prescriptive but allowed the team to figure out solutions that worked best for our circumstances. Yet, the methodologies employed by the ImPower program were generalizable and could help us tackle other problems in our practice.

Our group was involved in the first cohort of the follow-up recommendations group. We have been working to ensure radiologists follow the proper guidelines when available to make their recommendations and with our hospital system to ensure patients return for their necessary follow-up studies. Initially, my role was to secure buy-in from the practice to this commitment to the time and resources of the quality and safety team. Subsequently, my role morphed into working with the team to help ask the right questions while supporting them as we search for the best solutions. The baseline data we collected revealed challenges in accurately gathering data. ImPower encouraged us to define and measure performance more accurately.

As a result of participating, we developed an improved, collaborative relationship with our health system and referring providers. What started as a radiology-centered program became a health system-centered program. The teamwork and strategies learned to solve complex issues spill over to other practice areas, supporting a collaborative and just culture. From a quantitative perspective, more than 85% of our patients returned for their follow-up exams – an outstanding level – and our radiologists now follow the ACR guidelines when applicable 100% of the time. Perhaps the most meaningful measure of success is the feedback from patients who call the practice daily to share their gratitude for impacting their or their family members’ lives.