2022 Recap: ACR Annual Conference on Quality and Safety

In her keynote address, Pamela Johnson, MD, FACR, Vice Chair of Quality and Safety at Johns Hopkins Medicine Department of Radiology, kicked off the conference with a discussion about “Harmonizing the Drivers of Value-Based Care Transformation” — with a goal of helping the audience understand why provider-led value care redesigns are so important to improving clinical effectiveness and reducing cost of care. Johnson noted how patients, specifically younger patients, often avoid care because of the expense. Johnson further described how the quality of care needs to be monitored to find ways to reduce misdiagnoses and, thus, reduce cost. Johnson focused on how important communication is for this to work and provided an example of a radiology consult service she helped create at Hopkins to assist young radiologists and medical students in gaining access to answers from faculty members and specialties.

Johnson concluded by focusing on radiologists’ fear of missing something in images, leading to antibiotic overuse and prolonged/repeated hospitalizations. She noted how misinterpretation of certain phrases or words between radiologists and hospitals could lead to a misdiagnosis of a patient's condition, which leads to patients getting the wrong treatment and medicine. “I think it’s a tremendous opportunity for us in radiology,” said Johnson, “to show that we are at the beginning of all decision making, and we can drive better care longitudinally by measuring the quality, demonstrating the quality and improving the quality of what we are doing.”

Here are some highlights from various sessions at this year’s quality and safety conference.

Lung Cancer Screening (LCS) With Population Health

Ella Kazerooni, MD, FACR, Chair of the ACR Lung-RADS® Committee and Lung Cancer Screening Registry (LCSR), led a session on LCS and population health (early lung cancer detection). “It is reassuring to have a session on LCS and population health — considering lung cancer is the number one cause of cancer deaths in the country,” she said.

“A few things we learned through the 1.2 million screens in the LCSR, compared to the national population, is who are being screened more than we thought and who are not being screened enough,” Kazerooni says. “More Hispanic individuals are being screened than expected, for instance.” And more women than men are coming forward for screening, she added. Individuals eligible for LCS are disproportionately poor, uninsured and on Medicaid.

Kazerooni talked about early lung cancer detection programs, citing the LungPlan model, which is free, evidence-based and customer-focused (for clinicians, navigators and administrators). She also mentioned the revenue that could be gained by participating in the program. She thanked the audience for its interest in LCS. “We really can make a difference in lung cancer survivors,” she said. “And thanks to the ACR for its tremendous activity in this realm. The depth of knowledge that the ACR has is unparalleled.”

Kazerooni introduced Liora Sahar, PhD, GISP, Senior Director of Data Science with the American Cancer Society, to talk about population health and how geospatial mapping can be used to identify diverse populations at risk for lung cancer and how to close the gaps in screening. Shawn D. Teague, MD, FACR, Associate Professor at National Jewish Health/University of Colorado, then presented on using ACR LCSR data for performance improvement. Teague pointed out that while CMS no longer requires participation in the LCSR for reimbursement, participation in the registry continues to grow. “We are adding new measures to the registry, including new reports that help participants understand their performance and how it compares to their peers.”

Kazerooni concluded by thanking the speakers for “making QI practical, tangible, and doable — no matter what type of facility you are or what kind of resources you have.”

Pre-Conference Workshop: Point of Care Ultrasound

The Point of Care Ultrasound (POCUS) pre-conference session was moderated by Alexander Towbin, MD, FACR, who led the discussion about the importance of well-designed POCUS programs and introduced three organizations who described their journey building a program. Sonya Echols, PhD, and David Evans, MD, represented Virginia Commonwealth University Health Systems, David Waldman, MD, PhD, FACR, represented the University of Rochester Medical Center, and Jeannie Kwon, MD, represented the University of Texas Southwestern Children's Hospital. The panel shared about the factors that helped them build their POCUS programs, such as developing a business plan or framework, forming a POCUS committee/workforce, getting a good vendor and working together to form a workflow with other practices within the organization.

Follow-Up Recommendations

The “Follow-Up Recommendations” session was moderated by Ben Wandtke, MD, MMM, who highlighted the importance of organizations sharing their best practices to identify incidental findings, ensure patients receive proper follow-up care and implement a follow-up tracking system. Woojin Kim, MD, stressed the importance of making a proper plan for follow-up recommendations. Kim highlighted analyzing multiple methods to find the most effective way to track and implement follow-up exams. Regan City, PA-C, CPHQ, discussed a pilot study to help her organization develop a long-term tracking plan. City stressed the importance of making sure you are properly prepared to handle the workload and suggested interviewing radiologists to ensure everyone is on the same page. Neville Irani, MD, focused on closing the loop and developing relationships with patients to make sure they come back for follow-up exams. Chris Moore, MD, capped off the presentations by focusing on how to analyze data found through follow-up tracking. Moore talked about looking at disparity factors and communication processes to discover areas for improvement.

Breakout Session: Participating in a National Quality Improvement Learning Collaborative

The “Participating in a National Quality Improvement Learning Collaborative” breakout session was moderated by David Larson, MD, MBA, FACR, and Kandice Garcia Tomkins, MS, RN, who started the session by explaining that a learning network’s role is to facilitate meaningful improvement and highlighting how the ACR is using learning networks to help improve patient care. Various practices that participated in the first cohort of the ACR Learning Network then presented how the program is helping improve their practices.