Q&A With Chair of the ACR Commission on Quality and Safety

In this issue, we speak with Ben C. Wandtke, MD, MS, newly appointed Chair of the ACR® Commission on Quality and Safety about the specialty's evolving focus on quality and safety, the growing role of AI and his vision for the Commission in the years ahead.

According to former Chair David B. Larson, MD, MBA, “It is a privilege to pass the baton to Dr. Wandtke. He brings deep operational expertise, genuine passion for the field and a clear-eyed vision for where radiology quality must go next. The Commission is in excellent hands.”

And Wandtke says, “It’s an incredible honor to follow in the footsteps of Dr. Larson — a mentor of mine and truly the heart and soul of the radiology quality community. The past few weeks have been humbling as I've been oriented to the full scope and inner workings of the Commission. The College is truly strengthened by the engagement of so many dedicated volunteers.”

What opportunities are you most excited about as you take the helm of the Commission?

Dr. Wandtke: I believe the future of radiology is very bright. Radiology has been an early adopter of AI compared to many specialties, and we are well positioned to help shape how these technologies are integrated safely and effectively into clinical care — not just by adopting new tools, but by thoughtfully using them to improve diagnosis, streamline workflows and, ultimately, enhance patient outcomes.

At the same time, we have an important opportunity to improve how we understand and measure performance. Historically, measuring sustainability in improvement work has often been limited by the burden of manual data collection. Emerging tools — including AI-enabled workflows and more automated registry participation — offer the potential to make measurement more scalable and more accessible across a wide range of practice settings.

The growing collaboration between the ACR Commission on Quality and Safety and the ACR Informatics Commission positions the College to lead in this space. As we move forward, it will be critical that these solutions remain practical, cost-conscious and adaptable to the diverse environments in which radiologists practice.

What has the Commission accomplished over the past five years, and what is your vision going forward?

Dr. Wandtke: Given the breadth of work that falls under the Commission’s purview, any answer will inevitably be incomplete. The Commission on Quality and Safety is the largest Commission within the ACR, encompassing a dozen committees and more than a thousand radiologist volunteers — reflecting an extraordinary level of commitment to the specialty.

The Lung Cancer Screening Registry, now rebranded as the Early Lung Cancer Detection Registry, has expanded to include measures related to the management of incidental pulmonary nodules — an important step toward advancing imaging-based population health initiatives. As this work evolves, it will be important to ensure that new expectations are paired with workflows and systems that are feasible for practicing radiologists to use.

Continuous quality improvement is a core tenet of quality and safety. The Commission has advanced this principle through initiatives such as the ACR Learning Network, which utilizes the structured ImPower framework to educate members and their teams in improvement science while guiding organizations toward meaningful operational change. By linking registry data with practical performance improvement tools, the Commission aims to help organizations translate measurement into sustainable clinical, operational and financial improvement.

Building on a strong foundation, the Commission has also helped advance radiology toward a more integrated learning health system model. One important example is the continued evolution of peer learning, which has helped many practices move toward more collaborative, case-based review processes that support both education and patient safety.

In addition, the Commission continues to lead on accreditation, standards and appropriateness through ongoing updates to the ACR Appropriateness Criteria^®, Reporting and Data Systems (RADS) and Practice Parameters and Technical Standards (PP&TS). The Diagnostic Imaging Center of Excellence (DICOE) program was also redesigned to incorporate a multitiered framework that provides organizations with a clearer pathway toward achieving the College’s highest standards of imaging quality.

What are your top goals for the Commission in the coming year, and how do you plan to bring them to fruition?

Dr. Wandtke: My first priority is improving how we measure and improve performance. High-performing healthcare organizations are not those that simply aspire to excellence — they are those that can demonstrate it. Today, however, many important quality metrics still rely on time-intensive manual processes, limiting scalability and participation.

By working closely with the ACR Data Science Institute^®, we hope to develop tools that make data collection more efficient and more automated, lowering barriers to participation for practices of all sizes. At the same time, I want to better align our registries with the ACR Learning Network and other performance improvement resources, so that organizations not only measure performance, but also have clear, practical pathways to improve it. Ultimately, quality infrastructure should help radiology groups create meaningful clinical, operational and financial value.

Second, I want to continue advancing imaging-based population health initiatives. Radiology is uniquely positioned to identify disease earlier and improve outcomes through programs focused on cancer screening, incidental findings management and opportunistic screening. As these initiatives evolve, success will depend on thoughtful guideline development, structured data capture and workflows that integrate smoothly into real-world clinical practice while remaining sustainable for radiologists and health systems.

Third, I want to continue strengthening collaboration between the Commission on Quality and Safety and the ACR Data Science Institute around AI-enabled quality improvement. Programs such as ARCH-AI and ASSESS-AI have made important progress in helping organizations validate and monitor AI tools in clinical practice. The next step is moving beyond monitoring alone to defining meaningful measures of performance and helping organizations optimize how radiologists and AI systems work together to improve care.

Why are quality and safety in radiology more important than ever before?

Dr. Wandtke: Virtually every organization is facing significant challenges today — including workforce shortages, increasing imaging volumes and growing operational complexity. In many cases, hiring alone cannot fully solve these issues. That makes it even more important to focus on improving efficiency, reducing unnecessary variation and strengthening systems of care.

Performance improvement is, in many ways, radiology’s equivalent of research and development. Thoughtful investment in workflow optimization and waste reduction can help organizations maintain high-quality care while navigating real-world constraints.

At the same time, AI is becoming part of routine clinical practice. While these tools offer tremendous promise, we are still learning how best to validate, monitor and integrate them into clinical workflows. Quality and safety leaders will play an essential role in defining meaningful performance measures and ensuring that these technologies enhance — rather than complicate — patient care.

Why did you choose to focus on quality and safety, and what drew you to leading the Commission?

Dr. Wandtke: I stepped into a leadership role early in my career while working as a general radiologist at a community hospital. One of my first challenges was optimizing CT protocols to maximize image quality while limiting radiation exposure.

The ACR Dose Index Registry (DIR) provided the benchmarking data I needed to understand where we stood and how we could improve. That experience showed me how powerful quality infrastructure can be — especially for radiologists working in busy, real-world practice environments where time and resources are limited.

What became increasingly clear to me over time is that improving systems of care creates a multiplier effect. As radiologists, we impact patients one interpretation at a time, but when we improve the systems that support care delivery, we can expand that impact across an entire practice, department, health system or even nationally. Throughout my career, the focus of my efforts gradually expanded outward — from local operational challenges to broader initiatives aimed at improving care at scale — which ultimately led me toward deeper involvement within the ACR.

Over time, I realized this was where I could contribute most: Helping translate data, quality methodology and operational experience into practical improvements that benefit both patients and the radiologists delivering care.

Tell us about your ACR journey — from first getting involved — to becoming Chair.

Dr. Wandtke: My first meaningful involvement with the ACR came through the DIR, which helped me solve a real operational problem early in my career. That experience introduced me to the broader scope of what the College provides — from evidence-based guidance to practical tools that support clinical care and performance improvement.

Around that same time, I was invited to give my first national presentation at the ACR Annual Meeting more than a decade ago. I was incredibly impressed by the level of engagement, collaboration and commitment I saw among the volunteers and leaders involved in the organization. That experience motivated me to become more active within the College, eventually serving as a New York State Councilor.

From there, I became involved with the Informatics Commission through the ACR Data Science Institute, and I later took on leadership roles within the Quality and Safety Conference, the DICOE Committee and the ACR Learning Network. Each step provided additional perspectives on how the College supports radiologists across a wide range of practice environments and career stages.

Serving as Vice Chair of the Commission on Quality and Safety ultimately gave me a deeper appreciation for both the scale of the Commission’s work and the extraordinary volunteer commitment behind it. It is a tremendous honor to now step into the Chair role.

How do leadership, quality improvement and informatics intersect?

Dr. Wandtke: High-quality, reliable care requires alignment across three domains: Quality and safety expertise, informatics capability and organizational leadership.

Quality professionals help identify and solve problems systematically. Informaticists help build scalable, reliable solutions. And leadership is essential to provide direction, resources and long-term support. When these three elements work together, meaningful and sustainable improvement becomes possible.

Bringing the ACR Radiology Leadership Institute^® Summit together with the Quality and Safety + Informatics Conference (QS+I) reflects that reality. Radiologists who understand both leadership and performance improvement are better positioned to drive meaningful change within their organizations.

What advice do you have for radiologists who want to get more involved?

Dr. Wandtke: First, consider volunteering within the College. Whether you are in private practice or academic medicine, your perspective is important, and engagement often leads to meaningful professional and personal growth. The ACR offers tremendous opportunities to learn from colleagues across a wide range of practice environments and career stages.

Second, seek out mentorship and opportunities to build relationships with others in the field. The QS+I Conference is an excellent place to start — it is a focused setting where meaningful conversations, collaborations and long-term professional relationships often begin. Having mentors and a strong professional network can dramatically accelerate both personal growth and your ability to lead meaningful change.

Finally, identify a problem in your own practice and start working on it. You do not need to have all the answers — the ACR has resources available to help you. Some of the most meaningful quality improvement work begins with solving practical, local challenges that directly impact patients, radiologists and care teams.

The field of quality and safety continues to evolve rapidly, and there has never been a greater opportunity for radiologists to help shape the future of how care is delivered.

Any final thoughts?

Dr. Wandtke: I want to recognize the many individuals who contribute to the work of this Commission. The level of volunteer engagement is remarkable, and it reflects a shared commitment to improving patient care across the specialty.

My goal is to continue strengthening coordination across our programs, tools and technologies, so they work together in ways that are practical, measurable and aligned with the needs of radiologists in practice.

Ultimately, this work belongs to the entire radiology community. The more accessible, collaborative and impactful we can make it, the stronger our specialty will be.