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Quality assessment and improvement: what radiologists do and think.
AJR Am J Roentgenol. 1994 Nov; 163(5):1245-54.AA

Abstract

OBJECTIVE

The main objectives of the study were as follows: first to study the nature and extent of radiologists' involvement in and their attitudes toward quality assessment (QA) and continuous quality improvement (CQI)/total quality management (TQM) in hospitals and in offices; and second, to ascertain whether differences in size, type, and location among hospitals and nonhospital radiology offices affect the QA and CQI/TQM activities of radiologists. We analyzed data from a national survey conducted by the American College of Radiology (ACR) in 1993.

MATERIALS AND METHODS

Questionnaires about QA and CQI/TQM activities and attitudes were mailed to 216 hospital-affiliated diagnostic radiology group practices using a sample selected from the ACR master list of radiology practices in the United States. The response rate was 90%. A stratified random sample ensured representation of different geographic regions, various group sizes, and both academic and nonacademic groups. Responses were weighted so that our data show what answers about hospitals would have been if (i) the survey had been answered by all hospital radiology departments in the United States (except for those few staffed by solo practitioners or nonradiologists) and (ii) our questions about nonhospital offices had been answered by all radiology groups in the United States (except those few having no hospital activity).

RESULTS

The majority (86%) of hospital radiology departments report having a program to monitor and evaluate physicians' performances. Fifty-one percent collect incorrect diagnoses by specific radiologist. Twenty-eight percent collect some of their QA data through computerized information systems. We found some statistically significant differences by hospital size and location, with larger hospitals and urban hospitals being more likely to engage in some QA activities. Multivariate analyses, once controlled for hospital size and location, found no significant differences in QA activity between university and community hospitals or between hospitals with and without a residency program. QA and CQI programs were less common in offices than in hospitals. With the exception of mammographic interpretations, most practices did not monitor and evaluate physicians' performances in the office setting. Respondents representing 58% of hospital radiology departments thought that QA and CQI contributed to improvement in patient care. Only 19% of radiology practices answered that CQI has been of cost benefit to their organization.

CONCLUSION

Most radiology practices engage in a variety of QA and CQI activities in hospitals. However, this is less true in offices, in which radiologists have more discretion, and radiologists remain skeptical about the usefulness of CQI.

Authors+Show Affiliations

Research Department, American College of Radiology, Reston, VA 22091.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7976910

Citation

Deitch, C H., et al. "Quality Assessment and Improvement: what Radiologists Do and Think." AJR. American Journal of Roentgenology, vol. 163, no. 5, 1994, pp. 1245-54.
Deitch CH, Chan WC, Sunshine JH, et al. Quality assessment and improvement: what radiologists do and think. AJR Am J Roentgenol. 1994;163(5):1245-54.
Deitch, C. H., Chan, W. C., Sunshine, J. H., Zinninger, M. D., Cascade, P. N., & Cochran, S. T. (1994). Quality assessment and improvement: what radiologists do and think. AJR. American Journal of Roentgenology, 163(5), 1245-54.
Deitch CH, et al. Quality Assessment and Improvement: what Radiologists Do and Think. AJR Am J Roentgenol. 1994;163(5):1245-54. PubMed PMID: 7976910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality assessment and improvement: what radiologists do and think. AU - Deitch,C H, AU - Chan,W C, AU - Sunshine,J H, AU - Zinninger,M D, AU - Cascade,P N, AU - Cochran,S T, PY - 1994/11/1/pubmed PY - 1994/11/1/medline PY - 1994/11/1/entrez SP - 1245 EP - 54 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 163 IS - 5 N2 - OBJECTIVE: The main objectives of the study were as follows: first to study the nature and extent of radiologists' involvement in and their attitudes toward quality assessment (QA) and continuous quality improvement (CQI)/total quality management (TQM) in hospitals and in offices; and second, to ascertain whether differences in size, type, and location among hospitals and nonhospital radiology offices affect the QA and CQI/TQM activities of radiologists. We analyzed data from a national survey conducted by the American College of Radiology (ACR) in 1993. MATERIALS AND METHODS: Questionnaires about QA and CQI/TQM activities and attitudes were mailed to 216 hospital-affiliated diagnostic radiology group practices using a sample selected from the ACR master list of radiology practices in the United States. The response rate was 90%. A stratified random sample ensured representation of different geographic regions, various group sizes, and both academic and nonacademic groups. Responses were weighted so that our data show what answers about hospitals would have been if (i) the survey had been answered by all hospital radiology departments in the United States (except for those few staffed by solo practitioners or nonradiologists) and (ii) our questions about nonhospital offices had been answered by all radiology groups in the United States (except those few having no hospital activity). RESULTS: The majority (86%) of hospital radiology departments report having a program to monitor and evaluate physicians' performances. Fifty-one percent collect incorrect diagnoses by specific radiologist. Twenty-eight percent collect some of their QA data through computerized information systems. We found some statistically significant differences by hospital size and location, with larger hospitals and urban hospitals being more likely to engage in some QA activities. Multivariate analyses, once controlled for hospital size and location, found no significant differences in QA activity between university and community hospitals or between hospitals with and without a residency program. QA and CQI programs were less common in offices than in hospitals. With the exception of mammographic interpretations, most practices did not monitor and evaluate physicians' performances in the office setting. Respondents representing 58% of hospital radiology departments thought that QA and CQI contributed to improvement in patient care. Only 19% of radiology practices answered that CQI has been of cost benefit to their organization. CONCLUSION: Most radiology practices engage in a variety of QA and CQI activities in hospitals. However, this is less true in offices, in which radiologists have more discretion, and radiologists remain skeptical about the usefulness of CQI. SN - 0361-803X UR - https://www.unboundmedicine.com/medline/citation/7976910/Quality_assessment_and_improvement:_what_radiologists_do_and_think_ L2 - https://www.ajronline.org/doi/10.2214/ajr.163.5.7976910 DB - PRIME DP - Unbound Medicine ER -