Scientific Session 12 — SS12: Efficacy/Administration/Informatics - EducationWednesday, April 25, 2018
2685. Decreasing Radiology Resident Reporting Errors: A Single-Center Experience
Volin S*, Siewe D, Chapin R, Lewis M, Leddy R. Medical University of South Carolina, Charleston, SC
Address correspondence to S. Volin (email@example.com)
Objective: The technique section of the radiology report describes the methods in which the study was performed. Discrepancies between the report and the ordered study require the radiologist to generate an addendum to ensure accurate reporting and appropriate billing. An initial review at our institution revealed this to be a significant issue, causing delayed payments and hundreds of addenda monthly. Recognition of this significant but avoidable issue provided impetus for further investigation and intervention. By creating a plan to increase awareness and improve attention to detail in the technique section of the radiology report, we aimed to decrease the number of reports requiring addenda (RRA) and thus decrease the number of delayed payments.
Materials and Methods: Six months of baseline data was collected from October 2016 to March 2017, including total number of radiologic studies performed, number of RRA, number of addenda by imaging department, addenda by imaging modality, and reason for addenda. Individual resident errors were also recorded. Interventions were undertaken to educate the residents in the month of April. A presentation of the baseline data was given and the billing department provided information on improving dictation accuracy. Residents were emailed when they were responsible for an RRA. After the initial presentation in April, a monthly summary was sent to the class recapping the data, with frequent error types included. Individual resident errors were included for peer comparison. Monthly reminders about dictation errors were presented at resident conference. After the intervention, data for April 2017 to August 2017 was collected and presented in the same manner as preintervention. Our target was to decrease the percentage of RRA to below 0.50% of total studies.
Results: The baseline data from October 2016 to March 2017 demonstrated a mean of 26,604 studies per month, with a mean of 148 RRA per month (0.56% of total studies). The highest rate of RRA was 0.59% (October and November 2016 and March 2017). The lowest rate of RRA was 0.50% (December 2016). After interventions were performed, data was collected from April to August 2017, with a mean of 24,476 studies performed per month, and a mean of 110 RRA per month (0.45% of total studies). Individual monthly data are as follows: April 0.47%; May 0.52%; June 0.47%; July 0.38%; August 0.40%. The difference between preintervention and postintervention data was statistically significant (p = 0.0367). Incorrect documentation of contrast use was the most frequent reason for RRA, and the musculoskeletal division had the highest number of RRA.
Conclusion: Increasing awareness and attention to detail when residents generate a radiology report can substantially decrease RRA thus improving workflow and decreasing delayed payments. Residents at our institution have become more accountable, thoughtful and accurate in dictating, which is supported by the statistically significant decrease in RRA. This outcome stands to prepare residents for future high volume practice where accuracy and efficiency is paramount.