Quality improvement resources

We support our members by providing radiology-specific training and educational resources in practice assessment and quality improvement (QI). Curated by our Quality Improvement Committee (QIC), the following resources contain links to public and private organizations and institutions that provide educational information focused on QI standards, clinical guidelines and online learning.

Explore the topics covered on this page to get started:

  • RadioGraphics
  • Other news sources
  • Practice resources and guidelines
  • Performance measures and sources of evidence-based medicine
  • Free data for bench marking
  • External quality resources
  • Online learning resources

RadioGraphics

This RSNA journal features a quality initiatives section to help guide radiologists and radiology professionals to develop and implement continuous quality improvement in their practices.
2018
Troubleshooting Image Quality and Other Problems by Using the DICOM Header
William F. Sensakovic, David R. Warden, Matthew C. Hough (May-Jun 2018)

Current and Novel Techniques for Metal Artifact Reduction at CT: Practical Guide for Radiologists
Masaki Katsura, Jiro Sato, Masaaki Akahane, Akira Kunimatsu, Osamu Abe (Mar-Apr 2018)

Bias in Radiology: The How and Why of Misses and Misinterpretations
Lindsay P. Busby, Jesse L. Courtier, Christine M. Glastonbury (Jan-Feb 2018)

MR Imaging and Cochlear Implants with Retained Internal Magnets: Reducing Artifacts near Highly Inhomogeneous Magnetic Fields
Heidi A. Edmonson, Matthew L. Carlson, Alice C. Patton, Robert E. Watson (Jan-Feb 2018)
2017
Enabling the Next-Generation Radiology Report: Description of Two New System Standards
James Y. Chen, Teri M. Sippel Schmidt, Christopher D. Carr, Charles E. Kahn (Nov-Dec 2017)

Measuring and Establishing the Accuracy and Reproducibility of 3D Printed Medical Models
Elizabeth Georg, Peter Liacouras, Frank J. Rybicki, Dimitrios Mitsouras (Sep-Oct 2017)

Clinical Significance of US Artifacts
Michael Baad, Zheng Feng Lu, Ingrid Reiser, David Paushter (Sep-Oct 2017)

Decreasing Stroke Code to CT Time in Patients Presenting with Stroke Symptoms
Aleksandrs Kalnins, L. Jake Mickelsen, Daisha Marsh, Christoph Zorich, Stephanie Casal, Waimei Amy Tai, Nirali Vora, Gennette Olalia, Max Wintermark, David B. Larson (Sep-Oct 2017)

Correlate: A PACS- and EHR-integrated Tool Leveraging Natural Language Processing to Provide Automated Clinical Follow-up
Mark D. Kovacs, Joseph Mesterhazy, David Avrin, Thomas Urbania, John Mongan (Sep-Oct 2017)

CT Angiography in the Emergency Department: Maximizing Contrast Enhancement and Image Quality While Minimizing Radiation Dose and Contrast Material Volume: Vascular/Interventional Radiology
Toshimasa J. Clark, Martin L. Gunn (Jul-Aug 2017)

Diagnosis and Management of Complications from Percutaneous Biliary Tract Interventions
Nanda Venkatanarasimha, Karthik Damodharan, Apoorva Gogna, Sum Leong, Chow Wei Too, Ankur Patel, Kiang Hiong Tay, Bien Soo Tan, Richard Lo, Farah Irani (Mar-Apr 2017)

Troubleshooting to Overcome Technical Challenges in Image-guided Breast Biopsy 
Allyson L. Chesebro, Sona A. Chikarmane, Julie A. Ritner, Robyn L. Birdwell, Catherine S. Giess (May-Jun 2017)

Reducing Functional MR Imaging Acquisition Times by Optimizing Workflow
Wilson B. Chwang, Michael Iv, Jason Smith, Aleksandrs Kalnins, Jake Mickelsen, Roland Bammer, Dominik Fleischmann, David B. Larson, Max Wintermark, Michael Zeineh (Jan-Feb 2017)
2016
Artifacts at Cardiac CT: Physics and Solutions
Kevin Kalisz, Ji Buethe, Sachin S. Saboo, Suhny Abbara, Sandra Halliburton, Prabhakar Rajiah (Nov-Dec 2016)

Bariatric CT Imaging: Challenges and Solutions
Dzmitry 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 Procedures
Yvonne 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 Edition
Ajay 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)
2015
A Practical Guide to MR Imaging Safety: What Radiologists Need to Know 
Leo L. Tsai, MD, PhD, MSc, Aaron K. Grant, PhD, Koenraad J. Mortele, MD, Justin W. Kung, MD, Martin P. Smith, MD

Key Concepts of Patient Safety in Radiology 
David B. Larson, MD, MBA, Jonathan B. Kruskal, MD, PhD, Karl N. Krecke, MD, Lane F. Donnelly, MD

Patient-centered Radiology 
Jason N. Itri, MD, PhD

Statistics 101 for Radiologists 
Arash Anvari, MD, Elkan F. Halpern, PhD, Anthony E. Samir, MD, MPH
2014
RSNA Centennial Article: ALARA 1912: “As Low a Dose as Possible” a Century Ago
Alan E. Oestreich, MD (Sept - Oct 2014)

Methods for Clinical Evaluation of Noise Reduction Techniques in Abdominopelvic CT
Eric 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 Problems
Nathan E. Yanasak, PhD, Michael J. Kelly, MD (Mar - Apr 2014)

Daily Management Systems in Medicine
Lane F. Donnelly, MD (Mar - Apr 2014)

Improving Patient Access to an Interventional US Clinic
Joseph 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 Quality
Eren 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)
2013
Now You See It, Now You Don’t: Visual Illusions in Radiology
Christopher 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 Workflow
Carla 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, MDand Amy K. Hara, MD (July - Aug 2013)

Abdominal MR Imaging in Children: Motion Compensation, Sequence Optimization, and Protocol Organization
Govind B. Chavhan, Paul S. Babyn, and Shreyas S. Vasanawala (May - June 2013)

Special Editorial: Standardization of Quality Initiative Reporting
No 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 Department
Alexander 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 Department
Bettina 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 Interpretation
George 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)
2012
Statistical Control Charts: Simplifying the Analysis of Data for Quality Improvement
Yvonne 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 Implementation
T. Rob Goodman, MB, BChir and Maxwell Amurao, PhD, MBA (Oct 2012)

Planning, Setting Up, and Carrying Out Radiology Process Improvement Projects
Eric 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 Lactation
Emilie 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 Department
Jonathan 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 Program
Joseph R. Steele, MD, A. Kyle Jones, PhD and Elizabeth P. Ninan, PA-C (Jan - Feb 2012)
2011
Informatics in Radiology: RADIANCE: An Automated, Enterprise-wide Solution for Archiving and Reporting CT Radiation Dose Estimates
Tessa 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 Quality
Eric 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 Success
Jonathan 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 Radiologists
Mishal 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 Department
Eavan Thornton, MD, Olga R. Brook, MD, Mishal Mendiratta-Lala, MD, Donna T. Hallett, BS and Jonathan B. Kruskal, MD, PhD (Jan - Feb 2011)

Other news sources

Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services
Newswise
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.
Radiology
Special Report: Guide to Effective Quality Improvement Reporting in Radiology
By David B. Larson, MD, MBA, James R. Duncan, MD, PhD, Paul G. Nagy, PhD, Jonathan B. Kruskal, MD, PhD

Performance measures and sources of evidence-based medicine

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® : Guidelines to assist referring physicians and other health care providers in making the most appropriate imaging decisions; criteria may also be used to monitor ordering of appropriate  imaging.

American College of Radiology (ACR) Practice Parameters and Technical Standards: Educational tools to help guide decision-making by radiologists and patients planning and performing examinations, treatments and procedures.

PCPI®: The Physician Consortium for Performance Improvement 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: PCPI members approved the Optimizing Patient Exposure to Ionizing Radiation (OPEIR) work group to develop 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.

AHRQ Health Care Innovations Exchange: Allows health care professionals to share and adopt new innovations that improve care delivery.

AHRQ Quality Indicators: Standardized, evidence-based measures of health care quality that can be used with readily available hospital inpatient administrative data to measure and track clinical performance and outcomes.

National Committee for Quality Assurance (NCQA): Accredits, certifies and publicly recognizes organizations and physicians who participate in NCQA measurement activities; 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, endorses national consensus standards for measuring and publicly reporting on performance and promotes the attainment of national goals through education and outreach programs.

Center for Evidence-Based Medicine (CEBM): Tools to implement a project that evaluates practice against evidence-based medicine.

Free data for bench marking

Several national and federal organizations provide free access to limited administrative data that can be useful in bench marking process and outcomes within your own environment.

National Center for Health Statistics: Descriptive statistics on the general health of the American population.

HCUPnet: Free, online system providing health care statistics and information for hospital inpatient, emergency department and ambulatory settings, as well as population-based health care data on counties.

Consumer Assessment of Healthcare Providers and Systems (CAHPS®): Data from here can be used to assess patient satisfaction, compare and report on performance, and quality improvement assessment.

Center for Medicare and Medicaid Services: National Medicare and Medicaid population statistics, trends and reports.

Dartmouth Atlas of Health Care: Contains public data that can be used to produce reports on medical resources consumption at national, regional or local levels.

External quality resources

National and international resources that provide examples or templates of tools that can be used to maximize quality improvement.

Institute for Healthcare Improvement (IHI): Provides users with the ability to set up and document individual or team improvement projects, including data collection and track or trend changes over time.

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 Knowledge on Syque: Provides detailed explanations and examples of quality tools, including control charts.

"Improving Diagnosis in Health Care": National Academies of Science, Engineering and Medicine study report that can be purchased or downloaded for free with an account or as a guest.

Agency for Healthcare Research and Quality (AHRQ): U.S. Department of Health & Human Services agency providing tools to help design and support quality improvement programs and projects including:

International Atomic Energy Agency (IAEA): International agency promoting basic safety standards in radiation protection and safety.

The International Society of Radiology (ISR): Facilitator for continental, regional and national quality and safety campaigns in radiation protection. Its ISR Quality and Safety Alliance (ISRQSA) drives the ISR’s quality and safety agenda.

Online learning resources

Radiology Non-interpretive Skills Review: ABR Core Quality & Safety Study Guide: Series of 10 videos by David B. Larson, MD, MBA, Associate Chair of Performance Improvement, Department of Radiology, Stanford University.

American College of Radiology Learning Activities: A collection of self-assessments,  virtual courses and case studies from ACR.

Open School at the Institute for Healthcare Improvement: A global learning community working to build core skills in improvement, safety, system design and leadership.

  • Online courses
  • Video library
  • IHI Open School Change Agent Network (I-CAN)
Horizons School for Change Agents: A part of the National Health Service of England, this global community supports leaders, teams, organizations and systems to think differently about large-scale change, improve collaboration, and accelerate change. Registration occurs annually.