An evidence based protocol for peer review of radiographer reporting

Transcription

1 An evidence based protocol for peer review of radiographer reporting Poster No.: C-0030 Congress: ECR 2012 Type: Authors: Keywords: DOI: Educational Exhibit P. Stephenson, A. Hannah, H. Jones, R. Edwards, K. Harrington, S.-A. Baker, N. Fitzgerald, J. Belfield; Liverpool/UK Observer performance, Audit and standards, Plain radiographic studies, Management, Education, Trauma /ecr2012/C-0030 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 11

2 Learning objectives Given the paucity of guidance on how reporting radiographers should be audited, a practical framework for designing a reporting radiographer peer review process is provided. The following questions are answered: How frequently should peer review take place? How many reports should be reviewed? How are reports selected for review? Who should peer review the radiographer reports? How should radiographer reporting performance be measured? What standard of reporting is acceptable? Background The increasing involvement of radiographers in image reporting is well described in the current literature and continues to court controversy. Such controversy was intensified following the 2010 publications by the Royal College of Radiologists (RCR) 1 and Society and College of Radiographers (SCoR) concerning medical image interpretation by nonmedically trained staff 2. The aim of this article is to explain and evaluate a peer review system being utilised by a team of reporting radiographers in a large university teaching hospital; this safe practice has been embedded within the directorate for approximately three years. We aim to show that any potential risks associated with radiographer reporting can be monitored and mitigated if a robust peer review system is introduced. Imaging findings OR Procedure details The recommended peer review process is as follows: Formal peer review of radiographer reporting accuracy occurs every four months. Thirty randomly selected cases are reviewed by fellow reporting radiographers during each four month review period. Cases are stratified to include all body areas. Page 2 of 11

3 Cases are reviewed by fellow reporting radiographers and a MSK radiologist. 95% accuracy of reporting is expected annually for each reporting radiographer (>90% with 95% confidence assuming a binomial distribution). A consultant radiologist acts as an arbiter to the peer review process. The peer review method presented is not intended to produce robust statistical data; it is a practical method of locally assessing reporting competency. As such, the provided protocol (Figure 1) should be viewed as part of a larger programme for continuing professional development. The following example case illustrates how the peer review process aids performance in the radiology department. Case 1 - the patient underwent three separate images of the wrist and scaphoid, which were all reported as no fracture (Figure 2a). As the patient was symptomatic, the injury was treated as a fracture and the patient was followed appropriately. Upon peer review a fracture at the distal corner of the scaphoid was noted (Figure 2b). Images for this section: Page 3 of 11

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5 Fig. 0: Figure 1: the process of reporting radiographer peer review (with details of our methods) Fig. 0: Figure 2a: initial DP wrist, no fracture shown Page 5 of 11

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7 Fig. 0: Figure 2b: angled oblique scaphoid, fracture demonstrated at distal pole Page 7 of 11

8 Conclusion It should be stressed that, while peer review and audit can play a major role in maintaining competence, it is equally important that continuing professional development is seen as a continuous process. Other activities are encouraged alongside peer review and audit: Attendance at discrepancy meetings. Record of reflective learning. Attendance at local and national educational activities. It is hoped that this practical protocol will encourage radiology departments to engage in a programme of peer review for reporting radiographers. Figure 3 is a standard proforma for monitoring radiographer reporting performance; the annual confidence interval of reporting accuracy is calculated using the binomial distribution. Images for this section: Page 8 of 11

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10 Fig. 0: Figure 3: a proforma for recording radiographer reporting accuracy. 95% confidence calculated assuming binary distribution Page 10 of 11

11 Personal Information P. Stephenson, A. Hannah, H. Jones, R. Edwards, K. Harrington, S.A. Baker, N. Fitzgerald, J. Belfield. Department of Radiology, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK. Mail to: References 1. The Royal College of Radiologists. Medical image interpretation by radiographers: guidance for radiologists and healthcare providers. London: The Royal College of Radiologists, The Society of Radiographers. Medical image interpretation by radiographers: definitive guidance. London: The Society of Radiographers, Page 11 of 11