ARRS 2022 Abstracts

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E1064. Implementation and Positive Impact of a Radiology Peer Learning Program Within a Large Integrated Health Care Delivery System
Authors
  1. Tamara Oei; Mid Atlantic Permanente Medical Group
  2. Vincent Dam; Mid Atlantic Permanente Medical Group
  3. Romy Ott; Mid Atlantic Permanente Medical Group
  4. David Orange; Mid Atlantic Permanente Medical Group
  5. Michelle Forman; Mid Atlantic Permanente Medical Group
  6. Christopher Selhorst; Mid Atlantic Permanente Medical Group
  7. Ainsley MacLean; Mid Atlantic Permanente Medical Group
Background
Recognizing the need for systemic quality improvements in radiology to reduce diagnostic error, the American College of Radiology (ACR) has required radiology practices to implement PACS-based peer review systems, the most well-known being RADPEER — a score based, random assessment of prior reports. These traditional systems directed at quality improvement in radiology have recently become unfavorable due to concerns that they may discourage reporting of errors, create a negative learning climate, and cause lost opportunities for individual and system-wide learning. There is a growing movement within radiology to reframe discussions around this ACR assessment in the form of “peer learning,” which promotes an inclusive, nurturing, and positive environment to discuss errors and great calls or near misses. Since the inception of our own such peer learning program, where radiologists receive continuous individual feedback on cases and opportunities for collective learning through monthly conferences, we have seen growing enthusiasm from our diverse group of radiologists, with a 30-fold increase in case submissions compared with the pre-existing RADPEER system (> 1500 submissions versus 50 previously). Additionally, in our medical group’s physician opinion survey, we saw a 9% increase in our radiologists’ likelihood to strongly agree with the statement “the culture in my department makes it easy to learn from errors.” (3.97–4.33 out of 5).

Educational Goals / Teaching Points
The goals of this exhibit are to compare traditional methods of ACR peer review with the modern trend of peer learning in radiology; describe the structure of our peer learning program in a large integrated healthcare delivery system setting and steps required to successfully implement this program; and discuss how to measure success of a peer learning program through participation and responses on physician opinion surveys about learning climate.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This educational exhibit will discuss the current trends and rationale behind peer learning as a systemic mindset shift in how we address radiology error. We will describe our peer learning experience within our practice model (70 diagnostic and 10 interventional radiologists).

Conclusion
The newer methods of addressing diagnostic errors inherent in the daily practice of radiology are trending towards a nonpunitive, safe environment whereby learning is the primary emphasis by which quality improvements are achieved. Two possible direct measures of success of such a system are level of engagement of radiologists in submitting cases without fear of negative consequences and objectively measuring perceptions around learning climate on physician opinion surveys.