The RSNA Quality Improvement Committee (QIC) is dedicated to providing radiology-specific training and education resources to support members and their teams in facilitating practice assessment and QI. In addition to RSNA resources, the committee maintains a list of other public and private national organizations and institutions that provide professionals with educational opportunities focused on general aspects of QI skills and quality leadership.
An RSNA journal, RadioGraphics features a Quality Initiatives section to help guide radiologists and radiology professionals to develop and implement continuous quality improvement in their practices. Launched in 2008, the section features a growing collection of articles:
Artifacts at Cardiac CT: Physics and SolutionsKevin Kalisz, Ji Buethe, Sachin S. Saboo, Suhny Abbara, Sandra Halliburton, Prabhakar Rajiah (Nov-Dec 2017)Bariatric CT Imaging: Challenges and SolutionsDzmitry M. Fursevich, MD, Gary M. LiMarzi, MD, Matthew C. O’Dell, MD, MPH, Manuel A. Hernandez, MD, William F. Sensakovic, PhD (Jul-Aug 2016)No More Waits and Delays: Streamlining Workflow to Decrease Patient Time of Stay for Image-guided Musculoskeletal ProceduresYvonne Y. Cheung, MD, MS, Eric M. Goodman, MD, Tomiwa O. Osunkoya, MEM, ASQ CSSBB (May-Jun 2016)A Pictorial Review of Changes in the BI-RADS Fifth EditionAjay Aroor Rao, MD, Jennifer Feneis, MD, Chloe Lalonde, BA, Haydee Ojeda-Fournier, MD (May-Jun 2016)Should "Mature" Radiologists Be Put Out to Pasture?Ronald L. Eisenberg, MD, JD (May-Jun 2016)
The October 2015 Special Issue of RadioGraphics is devoted to Safety and Quality Articles. Highlights include:
CT of the Abdomen with Reduced Tube Voltage in Adults: A Practical ApproachAdeel R. Seyal, MD, Atilla Arslanoglu, MD, Samir F. Abboud, MD, Azize Sahin, MD, Jeanne M. Horowitz, MD, Vahid Yaghmai, MD (Nov-Dec 2015)
Microbiology for Radiologists: How to Minimize Infection Transmission in the Radiology DepartmentSobia K. Mirza, MD, Tyson R. Tragon, MD, Melanie B. Fukui, MD, Matthew S. Hartman, MD, Amy L. Hartman, PhD (July - August 2015)
Metrics for Radiologists in the Era of Value-based Health Care DeliveryAmmar Sarwar, MD, Giles Boland, MD, Annamarie Monks, MS, Jonathan B. Kruskal, MD, PhD (May - June 2015)
Optimizing Digital Mammographic Image Quality for Full-Field Digital Detectors: Artifacts Encountered during the QC ProcessRashmi Jayadevan, MD, M. Julie Armada, MD, Rola Shaheen, MD, Constance Mulcahy, RTR-M, Priscilla J. Slanetz, MD, MPH (Nov-Dec 2015)
The 10 Pillars of Lung Cancer Screening: Rationale and Logistics of a Lung Cancer Screening ProgramFlorian J. Fintelmann, MD, FRCPC, Adam Bernheim, MD, Subba R. Digumarthy, MD, Inga T. Lennes, MD, Mannudeep K. Kalra, MD, Matthew D. Gilman, MD, Amita Sharma, MD, Efren J. Flores, MD, Victorine V. Muse, MD, Jo-Anne O. Shepard, MD (Nov-Dec 2015)
The Malpractice Liability of Radiology Reports: Minimizing the RiskAparna Srinivasa Babu, MD, MRCS, Michael L. Brooks, MD, JD (Mar - Apr 2015)
RSNA Centennial Article: ALARA 1912: “As Low a Dose as Possible” a Century AgoAlan E. Oestreich, MD (Sept - Oct 2014)
Methods for Clinical Evaluation of Noise Reduction Techniques in Abdominopelvic CTEric C. Ehman, MD, Lifeng Yu, PhD, Armando Manduca, PhD, Amy K. Hara, MD, Maria M. Shiung, BA, Dayna Jondal, BA, David S. Lake, MS, Robert G. Paden, MS, Daniel J. Blezek, PhD, Michael R. Bruesewitz, RT,
Cynthia H. McCollough, PhD, David M. Hough, MD, Joel G. Fletcher, MD (July - Aug 2014)
MR Imaging Artifacts and Parallel Imaging Techniques with Calibration Scanning: A New Twist on Old ProblemsNathan E. Yanasak, PhD, Michael J. Kelly, MD (Mar - Apr 2014)
Daily Management Systems in MedicineLane F. Donnelly, MD (Mar - Apr 2014)
Improving Patient Access to an Interventional US ClinicJoseph R. Steele, MD, MMM, Ryan K. Clarke, MHA, John A. Terrell, MS, Tonya R. Brightmon, MS, RT (Jan - Feb 2014)
Positioning in Breast MR Imaging to Optimize Image QualityEren D. Yeh, MD, Dianne Georgian-Smith, MD, Sughra Raza, MD, Lisa Bussolari, RT (R) (MR), Jacqueline Pawlisz-Hoff, RT (R) (M) (MR), Robyn L. Birdwell, MD (Jan – Feb 2014)
Now You See It, Now You Don’t: Visual Illusions in RadiologyChristopher E. Buckle, MD1 , Viyan Udawatta, MD , Christopher M. Straus, MD (Nov - Dec 2013)
Quality Improvement and Confirmation Projects: Facilitating Rapid, Measurable Performance Improvement C. Matthew Hawkins, MD, Christopher N. Alsip, MHA, RT, Rebecca M. Pryor, BS, RT, Alan D. Leach, MS and David B. Larson, MD, MBA (Nov - Dec 2013)
Using Lean Principles to Improve Screening Mammography WorkflowCarla J. Shah, MD, Julie R. Sullivan, MD, Mary Beth Gonyo, MD, Anubha Wadhwa, MD and Melissa S. DuBois, MD (Sept - Oct 2013)
Reducing Radiation Dose in CT Enterography Andrew J. Del Gaizo, MD, Joel G. Fletcher, MD, Lifeng Yu, PhD, Robert G. Paden, MS, Garrett Clay Spencer, Shuai Leng, PhD, Annelise M. Silva, Jeff L. Fidler, MD, Alvin C. Silva, MD and Amy K. Hara, MD (July - Aug 2013)
Abdominal MR Imaging in Children: Motion Compensation, Sequence Optimization, and Protocol OrganizationGovind B. Chavhan, Paul S. Babyn, and Shreyas S. Vasanawala (May - June 2013)
Special Editorial: Standardization of Quality Initiative ReportingNo abstract available. James R. Duncan, MD, PhD, David B. Larson, MD and Jonathan B. Kruskal, MD, PhD (Mar - Apr 2013)
Decreasing Variability in Turnaround Time for Radiographic Studies from the Emergency DepartmentAlexander J. Towbin, MD, Srikant B. Iyer, MD, MPH, James Brown, MS, Kartik Varadarajan, PhD, Laurie A. Perry, RN and David B. Larson, MD, MBA (Mar - Apr 2013)
Strategies for Optimizing Staff Safety in a Radiology DepartmentBettina Siewert, MD, Olga R. Brook, MD, Misti M. Mullins, RN, Ronald L. Eisenberg, MD, JD and Jonathan B. Kruskal, MD, PhD (Jan - Feb 2013)
Medical Imaging Displays and Their Use in Image InterpretationGeorge C. Kagadis, PhD, Alisa Walz-Flannigan, PhD, Elizabeth A. Krupinski, PhD, Paul G. Nagy, PhD, Konstantinos Katsanos, MD, PhD, Athanasios Diamantopoulos, MD and Steve G. Langer, PhD (Jan - Feb 2013)
Statistical Control Charts: Simplifying the Analysis of Data for Quality ImprovementYvonne Y. Cheung, MD, MS, Boyoun Jung, BS, Jae Ho Sohn, MS and Greg Ogrinc, MD, MS (Nov - Dec 2012)
Medical Imaging Radiation Safety for the Female Patient: Rationale and ImplementationT. Rob Goodman, MB, BChir and Maxwell Amurao, PhD, MBA (Oct 2012)
Planning, Setting Up, and Carrying Out Radiology Process Improvement ProjectsEric P. Tamm, MD, Janio Szklaruk, MD, PhD, Leejo Puthooran, RT, Danna Stone, MBA, RN, Brian L. Stevens, BS and Cathy Modaro, MSIE (Sept - Oct 2012)
Guidelines for Use of Medical Imaging during Pregnancy and LactationEmilie Tremblay, MD, Eric Thérasse, MD, FRCPC, Isabelle Thomassin-Naggara, MD, PhD and Isabelle Trop, MD, MPH, FRCPC (May - June 2012)
Lean Approach to Improving Performance and Efficiency in a Radiology DepartmentJonathan B. Kruskal, MD, PhD, Allen Reedy, MBA, Laurie Pascal, MBA, MPH, Max P. Rosen, MD, MPH and Phillip M. Boiselle, MD (Mar - Apr 2012)
Establishing an Interventional Radiology Patient Radiation Safety ProgramJoseph R. Steele, MD, A. Kyle Jones, PhD and Elizabeth P. Ninan, PA-C (Jan - Feb 2012)
Informatics in Radiology: RADIANCE: An Automated, Enterprise-wide Solution for Archiving and Reporting CT Radiation Dose EstimatesTessa S. Cook, MD, PhD, Stefan L. Zimmerman, MD, Scott R. Steingall, RT, Andrew D. A. Maidment, PhD, Woojin Kim, MD, and William W. Boonn, MD (Nov - Dec 2011)
CT Radiation Dose Reduction: How to Implement Change without Sacrificing Diagnostic QualityEric P. Tamm, MD, X. John Rong, PhD, Dianna D. Cody, PhD, Randy D. Ernst, MD, Nancy E. Fitzgerald, MD and Vikas Kundra, MD, PhD (Nov - Dec 2011)
Quality Improvement in Radiology: Basic Principles and Tools Required to Achieve SuccessJonathan B. Kruskal, MD, PhD, Ronald Eisenberg, MD, JD, Jacob Sosna, MD, Chun Sham Yam, PhD, Joshua D. Kruskal and Phillip M. Boiselle, MD (Oct 2011)
Measuring and Managing the Procedural Competency of RadiologistsMishal Mendiratta-Lala, MD, Ronald L. Eisenberg, MD, JD, Joseph R. Steele, MD, Phillip M. Boiselle, MD and Jonathan B. Kruskal, MD, PhD (Sept - Oct 2011)
Application of Failure Mode and Effect Analysis in a Radiology DepartmentEavan Thornton, MD, Olga R. Brook, MD, Mishal Mendiratta-Lala, MD, Donna T. Hallett, BS and Jonathan B. Kruskal, MD, PhD (Jan - Feb 2011)
Lean Transformation for Radiology: Should Imaging Go Lean?By Deborah Abrams Kaplan
What Radiologists Should Do About Incidental FindingsBy Deborah Abrams Kaplan
Data Mining and Analytics in RadiologyBy Whitney L.J. Howell
New Software Pinpoints Size-Specific Dose Estimates for CTBy Leah Lawrence
National Voluntary Consensus Standards for Patient Safety Measures: A Consensus ReportWashington, DC: National Quality Forum
Joint Radiologist–Pathologist Review of Diagnostic Findings Improves Care of Patients Being Screened for Breast CancerBy Ossama Tawfik, MD, PhD, and Mark L. Redick, MD, PhD
and Spreading Quality Improvement: A Conversation With Julie Kliger,
MPA, BSN, Director, Integrated Nurse Leadership Program, University of
California San FranciscoBy The Innovations Exchange Team
2012 Annual Progress Report to Congress National Strategy for Quality Improvement in Health CareSubmitted by the U.S. Department of Health and Human Services
CT Cancer Risk Prompts High-tech Efforts to Cut Radiation DoseBy Kevin B. O'Reilly, amednews staff
Quality Metrics Seek to Slash Unneeded CT ScansBy Kevin B. O'Reilly, amednews staff
New Online Portal for Residents Focuses on Safety, Quality CareNEWS IN BRIEF
Project Tallies Lifetime Radiation from Health ScansBy Christine S. Moyer
ASTRO and AAPM Announce Launch of RO-ILS: Radiation Oncology Incident Learning System™New patient safety initiative will educate and facilitate safer and higher quality radiation oncology care
Special Report: Guide to Effective Quality Improvement Reporting in RadiologyBy David B. Larson, MD, MBA, James R. Duncan, MD, PhD, Paul G. Nagy, PhD, Jonathan B. Kruskal, MD, PhD
Use references from national agencies and professional societies to meet quality improvement standards.
Agency for Health Care Policy and Research (AHCPR): Clinical Practice Guidelines and Quick Reference Guides for Physicians »
National Guideline Clearinghouse »
American Academy of Neurology and the Child Neurology Society: Neuroimaging of the Neonate »(endorsed by the American Academy of Pediatrics, the American Society of Pediatric Neurology and the Society for Pediatric Radiology)
American Medical Association (AMA) »
British Columbia (BC) Cancer Agency: Cancer Management Guidelines »
CMA Online (Canadian Medical Association): Clinical Practice Guidelines (CPG) Infobase (in English and French) »
Dansk RadiologiskSelskab (Danish Society of Radiology): European Guidelines on Quality Criteria for Computed Tomography »
U.S. Preventive Services Task Force: Guide to Clinical Preventive Services »
IBUS Guidelines for the Ultrasonic Examination of the Breast »
Radiological Society of South Africa: Guidelines for CT and MR Examinations »
U.S. Nuclear Regulatory Commission »
Radiological Society of North America (RSNA) Practice Resources provides links to various clinical guidelines and measures for use in providing evidence-based practice and in designing systems to support quality care.
American College of Radiology (ACR) Appropriateness Criteria® has published guidelines to assist referring physicians and other healthcare providers in making the most appropriate imaging decisions. These criteria may also be used to monitor ordering of appropriate imaging.
American College of Radiology (ACR) Practice Guidelines and Technical Standards provides educational tools to help guide decision-making by radiologists and patients planning and performing examinations, treatments, and procedures.
Physicians Consortium for Performance Improvement (AMA/PCPI or The Consortium) is a developer of evidence-based measurement instruments used by various medical and surgical specialties, including radiology and nuclear medicine.
Optimizing Patient Exposure to Ionizing Radiation Measure Set Approved
The Physician Consortium for Performance Improvement® (PCPI®) membership recently voted to approve the Optimizing Patient Exposure to Ionizing Radiation (OPEIR). The Work Group developed this set of measures to identify and define quality measures toward improving outcomes for patients by reducing ionizing radiation necessary to perform an imaging study while preserving the highest diagnostic image quality. The measures were developed by the PCPI and the American Board of Medical Specialties in collaboration with the American College of Radiology and the American Board of Radiology.
Health Care Innovations Exchange is a new AHRQ program that allows health care professionals to share and adopt new innovations that improve care delivery.
National Quality Measures Clearinghouse (NQMC) is maintained by AHRQ and is a repository for evidence-based quality measures and measurement sets. The Consortium's measurement sets can be found in NQMC.
National Guidelines Clearinghouse (NGC) is maintained by AHRQ and is a repository for evidence-based clinical guidelines. ACR's Guidelines and Standards can be found in NGC.
Quality Indicators are measures of quality associated with processes of care that occur in an outpatient or an inpatient setting. The measurement process uses administrative data captured from preventive care treatments, patient safety, inpatient care, and pediatric measures. Preventive care, patient safety, inpatient care, and pediatric indicators includes pages of detailed instructions on how to implement the measurement process.
National Committee for Quality Assurance (NCQA) accredits, certifies, and publicly recognizes organizations and physicians who participate in NCQA measurement activities. NCQA also develops process measures that are used by health plans for the purposes of reporting the quality of care delivered to their enrollees.
National Quality Forum (NQF) identifies national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs.
Ambulatory Care Quality Alliance (AQA) is a developer of measurement instruments for use at the individual or group level. The mission and goals of AQA focus on key areas that can help identify quality gaps and control costs.
Several national and federal organizations provide free access to limited administrative data. This data is useful in benchmarking process and outcomes within your own environment.
National Center for Health Statistics provides descriptive statistics on the general health of the American population.
Health Cost and Utilization Project - HCUPnet provides data on patient demographics and resource utilization for defined diagnoses and procedures in a variety of healthcare
Consumer Assessment of Healthcare Providers & Systems (CAHPS) data can be used to assess patient satisfaction, compare
and report on performance, and quality improvement assessment.
Center for Medicare and Medicaid Services provides national Medicare and Medicaid population statistics, trends, and reports.
Dartmouth Atlas of Healthcare contains public data that can be used to produce reports on medical resources consumption at national, regional, or local levels.
The following resources provide examples or templates of tools that can be used to maximize quality improvement.
IHI (Institute for Healthcare Improvement):This program provides the user with the ability to set up and document individual or team improvement projects, including data collection, and track or trend changes over time.
CEBM (Center for Evidence-based Medicine): Tools to implement a project that evaluates practice against evidence-based medicine.
Agency for Healthcare Research and Quality: Provides tools to help design and support quality improvement programs and projects.
Physician Consortium for Performance Improvement® (PCPI®) Measures: Encompasses structure, process and outcome for evaluating quality of care for a wide range of clinical topics. The newly approved PCPI Approved Quality Measure:Optimizing Patient Exposure to Ionizing Radiation is now available for viewing under the Practice Resources and Guidelines tab below.
Patient Safety Tools and Resources: Information, reports, and tools for healthcare providers to support patient safety programs. Also provides information for consumers on how to partner with their health care team to ensure a safe experience.
Health Care Innovations Exchange: Recently developed by AHRQ, this program is designed for health care professionals to share and adopt innovations that improve care delivery to patients. The site includes innovative strategies and quality-related tools, how to improve your organization’s ability to innovate and adopt new ideas, and interact with others with the same concerns, interests, and goals.
Consumer Assessment of Healthcare Providers and Systems: This survey allows the healthcare provider to assess the patient’s experiences while receiving healthcare in a practice or healthcare facility. This tool can be used for patients seen in ambulatory, freestanding, and acute care settings.
Physician Practice Patient Safety Assessment: This assessment tool can be used by any type of radiology practice to assist in identifying opportunities to improve care in the area of patient safety.
Quality Tools & Definitions: This site provides detailed explanations and examples of quality tools, including control charts.
International Commission on Radiological Quality and Safety (ICRQS), a Standing Committee of the International Society of Radiology (ISR).
The International Society of Radiology has established the International Commission on Radiological Quality and Safety (ICRQS), and the RSNA has two representatives to the ICRQS.
Radiation Protection and Safety of Radiation Sources: International Basic Safety StandardsInternational Atomic Energy Agency (IAEA)