Keywords:
Workforce, Quality assurance, Education and training, Education, Audit and standards, Teleradiology, RIS, CT, Professional issues, Management
Authors:
L. I. Lanczi 1, F. Pusztai2, P. Bagyi2; 1Debrecen, Hungary/HU, 2Debrecen/HU
DOI:
10.26044/ecr2019/C-3339
Methods and materials
The department provides teleradiology CT reading services for a smaller hospital in the region,
among others.
A web-based PACS (eRad PACS,
eRad Inc.) is used for sharing all patient clinical and imaging data and for reporting.
Emergency cases are reported promptly while elective cases has a longer reporting time (72 hours).
These elective studies are allocated for the peer-review initiative,
has the largest quantity share among all peer-reviewed studies at the department,
therefore has a different workflow.
Workflow
- All elective cases are distributed for a first and second reader by a coordinating radiologist (not fixed first and second reader pairs!).
- First reader (a radiologist-in-training after at least 2 years of training) does the first reading within 24 hours.
On a daily basis at minimum 2-3 (maximum 5) CT studies are allocated to one first reader.
- Second reader (an experienced radiologist,
in some cases a sub-specialist) does the second reading within 72 hours,
finalizes the report,
fills an online feed-back form and gives direct feedback to the first reader.
Second readers receive extra payment based on quantity.
- First and second reading is prefereably done at home,
or at the workplace,
but separated from the regular workplace schedule.
- Based on online feedback data,
monthly meetings and discussions are held.
Feed-back form
Feed back form is a web-based form,
filled up by the second readers.
There are three categories of feed-back on a five-grade scale
- accuracy (focusing on radiological description)
- clinical relevance (focusing mainly on clinical question and radiological impression)
- linguistics (typography,
grammatical issues,
clarity of communication of the findings)
While there is a free text response field available to comment on grades except from 5 (addendum).
Second reader gives oral or written feedback to the first reader.
The feed back-form does not contain any patient data,
while all doctors have accepted the participation in the peer-review project so it meets the GDPR and other legal criteria.
Fig. 6: Peer-review feed-back form for the second readers (Hungarian). Some simple questions, easy to fill.
References: Department of Central Radiology Diagnostics, University of Debrecen, Kenézy University Hospital, Debrecen, Hungary, 2019