Radiographer Advanced Practice in Clinical Reporting Quality assurance by continuous audit : a five year review Gavin Cain & William Verrier Advanced Practitioner Radiographers (SCoR accredited) Results Background Peer review audit Conclusion and recommendations Criterion Audit Guideline Frequency Reports audited on a monthly basis Number of reports reviewed 5% sample Report selection A random 5% sample of each reporting radiographer’s caseload is generated using the Insignia PACS Patient explorer Reviewer Reporting radiographer/s on rotation with a consultant musculoskeletal radiologist as arbiter Performance measure / standard 95% accuracy standard (accuracy = agreed reports / total number reviewed reports) Results Results are available on the reporting radiographer shared drive. Significant reporting discrepancies will be reviewed Learning needs Failure to achieve 90% or three consecutive months in which 95% is not achieved will require a review period of double reporting with a named radiologist until the required standard is consistently met. Furthermore, areas for improvement / additional training needs must be identified Methodology Follow up action Measuring agreement The team Accordance Description No disagreement This includes normal anatomical variants Minor disagreement Unreported insignificant / clearly irrelevant abnormality Disagreement – “no clinical impact” Unreported traumatic and non-traumatic pathology is marked as a disagreement with "no clinical impact” if it is unlikely to influence patient management Disagreement – “clinical impact” Unreported traumatic and non-traumatic pathology is marked as a disagreement with “clinical impact” if it is likely to influence / impact on patient management Results 0 2 4 6 8 10 2015 2016 2017 2018 2019 0 2 1 1 3 1 7 10 7 4 Number of discrepancies Clinical impact of discrepancies Disagreement- clinical impact Disagreement- no clinical impact 35.201 45.232 64.937 65.378 71.741 0 10 20 30 40 50 60 70 80 2015 2016 2017 2018 2019 Number of reports Thousands Total Report Output 90% 91% 92% 93% 94% 95% 96% 97% 98% 99% 100% 2015 2016 2017 2018 2019 99.9% 99.6% 99.6% 99.7% 99.8% Accuracy (%) Sample report accuracy Benchmark accuracy References Acknowledgements
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Radiographer Advanced Practice in Clinical Reporting
Quality assurance by continuous audit : a five year review
Gavin Cain & William Verrier
Advanced Practitioner Radiographers (SCoR accredited)
Results
Background
Peer review audit
Conclusion and recommendations
Criterion
Audit Guideline
Frequency Reports audited on a monthly basis
Number of reports
reviewed
5% sample
Report selection A random 5% sample of each reporting
radiographer’s caseload is generated using the
Insignia PACS Patient explorer
Reviewer Reporting radiographer/s on rotation with a
consultant musculoskeletal radiologist as arbiter
Performance
measure / standard
95% accuracy standard (accuracy = agreed reports /
total number reviewed reports)
Results Results are available on the reporting radiographer
shared drive. Significant reporting discrepancies will
be reviewed
Learning needs Failure to achieve 90% or three consecutive months
in which 95% is not achieved will require a review
period of double reporting with a named radiologist
until the required standard is consistently met.
Furthermore, areas for improvement / additional
training needs must be identified
Methodology
Follow up action
Measuring agreement The team
Accordance
Description
No disagreement This includes normal anatomical variants
Minor disagreement Unreported insignificant / clearly irrelevant abnormality
Disagreement – “no clinical impact” Unreported traumatic and non-traumatic pathology is marked as a disagreement with "no clinical impact” if it is
unlikely to influence patient management
Disagreement – “clinical impact” Unreported traumatic and non-traumatic pathology is marked as a disagreement with “clinical impact” if it is likely
to influence / impact on patient management
Results
0
2
4
6
8
10
2015 2016 2017 2018 20190
2 1 1
3
1
7
10
7
4
Nu
mb
er
of
dis
cre
pa
ncie
s
Clinical impact of discrepancies
Disagreement- clinical impact Disagreement- no clinical impact
35.201
45.232
64.937 65.378
71.741
0
10
20
30
40
50
60
70
80
2015 2016 2017 2018 2019
Nu
mb
er
of
rep
ort
s Th
ou
sa
nd
s
Total Report Output
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
2015 2016 2017 2018 2019
99.9% 99.6%
99.6% 99.7% 99.8%
Accu
racy
(%)
Sample report accuracy
Benchmark accuracy
References
Acknowledgements
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