August 13, 2020

Get Started in Quality and Safety

Jennifer Broder, MD, is vice chair of quality and safety at Lahey Hospital and Medical Center and vice chair of the ACR Commission on Quality and Safety.

Confident young male professor explaining multi-ethnic students in community college classroom

A knock on my office door from a resident. A question at the end of a lecture to medical students. An email to my inbox, sender unknown. “I am interested in working in quality and safety, but don’t know how to get started.”

Quality and safety (QS) is not simply an administrative task, but rather a specialty in and of itself, requiring depth of expertise, as for any other specialty. There is no single route to becoming a competent expert in QS. Your path will be defined by your particular interests. QS is remarkable for its breadth of content, ranging from culture of safety to dose reduction to patient-centered care. Whatever your focus, you will, by necessity, build the knowledge base and skills you need to excel in that area. If you are interested in producing and leading change, you must understand the broader field as well. Since there are few training programs in this area, it will take initiative to study sufficiently to prepare yourself for this work.

So, how do you get started?

  1. Read
    Dive into the radiology QS literature to familiarize yourself with the language and processes of improvement and learn how other practices approach problems. Also, keep an eye out for useful articles in the general medical literature. Be discriminating about what you read. There is a lot of misinformation or misinformed opinion out there that passes for QS expertise. Prepare yourself to be able to differentiate quickly between true expertise from uninformed opinion.
  2. Ask questions
    How does your practice accomplish the daily tasks of QS? For instance, how is the quality of technologist and physician work managed? Who prepares for accreditation inspections and what content do they focus on? Who is responsible for patient experience? Who responds to medical errors?
  3. Browse
    Explore the ACR website to look for resources to support those daily tasks of managing and improving QS. Knowing what resources are available from the start will help you maximize efficiency and avoid reinventing the wheel.
  4. Show up
    If you start showing up in the places where you are interested in belonging, you may eventually be invited to participate. Find out where QS is discussed, both in your practice and at higher levels in your organization. Ask if you can sit in on a few meetings, listen closely and learn, then volunteer to help when appropriate. I guarantee opportunities will appear.
  5. Learn from experts
    Many opportunities exist to learn from the experts. Start by attending the high-yield annual ACR Q&S Conference, which this year will be virtual and easily accessible.
  6. Make a list.
    Make a list of everything that drives you crazy in your daily work. Then, choose a small, focused, solvable problem on that list, look to the literature for how others have managed the problem, and get to work.
  7. Build friendships.
    Meeting other people locally and nationally who are also passionate about QS is extremely rewarding. Connect with people on areas of shared interest first, then get to know them through those conversations. Eventually, you will seek them out to troubleshoot, collaborate, or open doors for each other. You will accomplish so much more together than working alone.
  8. Prepare to lead.
    Almost all work in QS requires change, and all change requires leadership. You will need to be ready to lead. Fortunately, the ACR’s Radiology Leadership Institute is available to help you develop the necessary skills.