Online Error Reporting for Managing Quality Control Within Radiology

Abstract

Information technology systems within health care, such as picture archiving and communication system (PACS) in radiology, can have a positive impact on production but can also risk compromising quality. The widespread use of PACS has removed the previous feedback loop between radiologists and technologists. Instead of direct communication of quality discrepancies found for an examination, the radiologist submitted a paper-based quality-control report. A web-based issue-reporting tool can help restore some of the feedback loop and also provide possibilities for more detailed analysis of submitted errors. The purpose of this study was to evaluate the hypothesis that data from use of an online error reporting software for quality control can focus our efforts within our department. For the 372,258 radiologic examinations conducted during the 6-month period study, 930 errors (390 exam protocol, 390 exam validation, and 150 exam technique) were submitted, corresponding to an error rate of 0.25 %. Within the category exam protocol, technologist documentation had the highest number of submitted errors in ultrasonography (77 errors [44 %]), while imaging protocol errors were the highest subtype error for computed tomography modality (35 errors [18 %]). Positioning and incorrect accession had the highest errors in the exam technique and exam validation error category, respectively, for nearly all of the modalities. An error rate less than 1 % could signify a system with a very high quality; however, a more likely explanation is that not all errors were detected or reported. Furthermore, staff reception of the error reporting system could also affect the reporting rate.

Medical error reporting software program development and its impact on pediatric units’ reporting medical errors

“…Consistently, previous studies managed to increase reporting rates when the reporting was anonymous and performed on web-bases systems. 11,12,15 An evaluation of the rates of the reported errors showed that medication errors were the most frequently reported events. The types and frequencies of medication errors indicated that dosage calculation errors were common The complicated calculations of small dosages for children increase the occurrence rates of these errors.…”

“…10 The relevant literature focuses on the importance of anonymous reporting systems that are addressed to increasing the number of reports by eliminating barriers that interfere with reporting errors by health professionals. 11 Examination of various web-based reporting systems developed around the world shows that there are specific reporting systems such as anonymous, web-based standardized monitoring techniques 12 and medication error reporting systems, 13 Electronic Clinic Safety Reporting System, which are developed for hospitals. 14 Users enter texts about what happens during the reporting, which are not configured, as well as the classified and coded structures of data.…”

Implementation of a Point-of-Care Radiologist-Technologist Communication Tool in a Quality Assurance Program

“…Golnari et al [7] conducted a study in which they assessed the impact of point-of-care feedback by purchasing and implementing a commercially available tool, also similarly integrated with the PACS in a multifacility radiology department. In that study, the issue submission rate was 0.25% of overall examination volume compared with 0.6% in our data.…”

“…The cost of the commercially available tool was also not reported. Cost comparisons can readily be made by obtaining quotes from that vendor [7]. …”

“…The issue categories that we defined were chosen on the basis of the perceived needs of our radiologists and technologists. Golnari et al [7] defined a different set of examination categories. For the purposes of addressing quality concerns within an institution, it may be reasonable and expedient to allow interinstitutional variability in issue category definitions.…”