Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow
To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria.
Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting.
The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001.
The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well.
• Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals.
• A clinical cancer network provides opportunities to improve healthcare.
• Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality.
• Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement.
KeywordsQuality assurance, healthcare Radiology information systems Medical oncology Interdisciplinary communication Health facility merger
Picture Archiving and Communication System
Plan Do Check Act
Response Evaluation Criteria in Solid Tumours
The authors thank the administrative staff, the technicians, the PACS administrators, the radiologists and the oncologists for participating in the project.
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is P.M.A. van Ooijen MSc PhD.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was not required for this study because patient data were anonymously used for the study and no interventions took place for the study.
Institutional Review Board approval was not required because of the retrospective nature of the study.
• performed at one institution
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