International Radiology Quality Network

IRQN    Collaboration is strength

Performance metrics / indicator and benchmarking project

It is recognized that the collection and analysis of performance metrics (PM) / performance indicators (PI) is an important first step in the application of the quality cycle in practices to improve patient care, i.e. measure performance, analyse issues, develop solutions, implement changes and monitor outcomes. The IRQN supports a systematic and holistic approach to examine the micro-processes involved in the delivery of radiology services from procedure requesting to report finalization and to identify those important, useful and measurable PM/PI to be developed. Radiologists play an important leading role in many of these processes but other factors and stakeholders are also involved which can influence the overall outcome.

In March 2007, an IRQN Performance Metrics / Indicators & Benchmarking Project workshop was held. The participants reported the workshop outcomes to the IRQN members in a subsequent meeting. The IRQN members agreed to undertake a pilot project on PI/PM by initially developing and defining an indicator and piloting data collection. These steps will help to identify the issues involved with such multi-national, multi-facility undertaking prior to the development of a more comprehensive benchmarking project internationally.

The Performance Metrics and Indicators Project Workgroup selected the turn around times (TATs) for radiology reports as the metrics to be benchmarked. Thirteen facilities from three continents took part in a trial in 2007. Based on the trial experience, data collection and methodology were refined. RIS vendors provide TAT data differently; e.g. either as % reported in 24, 48 or 72 hours or the average time required to generate a report in-hours or after-hours. The IRQN will work with the industry leaders to harmonize these data in future software updates to facilitate and streamline benchmarking.

Another round of data collection took place towards the end of 2008. Data was collected over a 3 months period from September. Participation was voluntary and based on RIS vendors’ introduction, direct recruitment through members of the Performance Metrics and Indicators Working Group and newsletters. Despite an initial expression of interest from thirty three facilities, the actual number participated was sixteen. The preliminary resulted were tabled in the recent IRQN meeting in March 2009. This project confirmed that it was possible to cooperate across different countries on benchmarking projects of this kind. However, further refinement of the project design, survey methodology and enrolment of more participating facilities are needed. Furthermore, member organisations were invited to identify other quality indicators which would be of relevance / importance to their membership for future benchmarking purpose.

In the interim period, those facilities participated will receive de-identified results for their review. A renewed recruitment drive will be undertaken through each of the IRQN member organizations. An invitation letter containing project background and a summary of the interim results will be provided to each IRQN member organization to inform their radiologists and to encourage them to participate in the next survey.

The TAT data is a small subset of the routine statistics generated by a facility’s RIS at the end of each month. Therefore, the additional effort for a participating facility is minimal. The project will provide us with a better insight into the performance of different types of facilities across the globe. Each facility can benchmark its performance against other similar facilities and identify areas of improvement. Each facility’s participation will be acknowledged and the data collected will remain confidential. After analysis, each participant will receive a report containing its own and de-identified aggregated data for comparison.

Interested facilities could provide their name and contact details to Laura Coombs Ph.D. at: The Workgroup looks forward to hearing from and working with you!

The network is very grateful to those facilities which have participated so far. The IRQN acknowledged the support from and expert assistance provided by the American College of Radiology in this project. In particular, thanks were conveyed to Ms. Pam Wilcox and Dr. Harvey Neiman for liaising with RIS vendors and to Dr. Laura Coombs for coordinating the data collection.


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A team of IRQN Referral Guidelines Working Group members were invited to a WHO consultancy on “Referral Guidelines for Appropriate Use of Radiation Imaging” in its Geneva HQ during March 2010.  The 35 invited experts from 19 countries representing 23 international, regional and national agencies and professional organizations have agreed to collaborate and work towards the common objective and develop a common set of referral guidelines on an appropriate use of diagnostic imaging and interventional procedures.  The experts also agreed that it was feasible to conduct an international project to achieve this goal…   More here

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