We’re Not Perfect…But We Want to Be!

I have now been a radiology fellow at Cincinnati Children’s for six months. It’s been an incredible training experience so far, and I’ve had the privilege of working with an amazing group of people. A number of attributes make this department great, but the one I have found most striking in my time here is the department’s uncompromising commitment to quality improvement.

Quality improvement as a concept can be generally defined as a formalized, systematic approach to performance assessment and improvement. Although this concept has long been important in business and industry, it is a relative newcomer to medicine. In medicine we always just assumed that we were doing a good job – after all, we were well trained and had good intentions. The Cincinnati Children’s Radiology Department has embraced this concept wholeheartedly, even obsessively. We don’t just want to THINK we are doing a good job anymore, we want to KNOW that we are providing the best possible overall radiology experience your child can have. And if we aren’t quite living up to those standards, we want to identify the problem and fix it as rapidly as we can.

Photo: Digital “Dashboard”

The foundation for any quality improvement initiative is data. In order to improve, you have to have some measure of how you are performing currently. In our department we track the number and type of studies we perform as well as the time it takes us to interpret those studies on our own version of a “dashboard” displaced prominently in our work area. We have an electronic mechanism that allows anyone in the Cincinnati Children’s medical system, and even in our own department, to raise any concerns they have with their radiology experience. We track the quality of our own interpretations through an anonymous peer review process that everyone participates in. Most importantly though, we listen to the patients and families we care for and record their feedback. Every three months all of this data is processed by our quality improvement team and presented to the entire department for discussion and debate. At these meetings we learn that we still aren’t perfect, but we make changes to get there!

Contributed by Dr. Andrew Schapiro and edited by Dr. Alex Towbin.