Golnari Pedram, Forsberg Daniel, Rosipko Beverly, Sunshine Jeffrey L
Department of Radiology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
Sectra, Teknikringen 20, Linköping, SE-583 30, Sweden.
J Digit Imaging. 2016 Jun;29(3):301-8. doi: 10.1007/s10278-015-9820-6.
Information technology systems within health care, such as picture archiving and communication system (PACS) in radiology, can have a positive impact on production but can also risk compromising quality. The widespread use of PACS has removed the previous feedback loop between radiologists and technologists. Instead of direct communication of quality discrepancies found for an examination, the radiologist submitted a paper-based quality-control report. A web-based issue-reporting tool can help restore some of the feedback loop and also provide possibilities for more detailed analysis of submitted errors. The purpose of this study was to evaluate the hypothesis that data from use of an online error reporting software for quality control can focus our efforts within our department. For the 372,258 radiologic examinations conducted during the 6-month period study, 930 errors (390 exam protocol, 390 exam validation, and 150 exam technique) were submitted, corresponding to an error rate of 0.25 %. Within the category exam protocol, technologist documentation had the highest number of submitted errors in ultrasonography (77 errors [44 %]), while imaging protocol errors were the highest subtype error for computed tomography modality (35 errors [18 %]). Positioning and incorrect accession had the highest errors in the exam technique and exam validation error category, respectively, for nearly all of the modalities. An error rate less than 1 % could signify a system with a very high quality; however, a more likely explanation is that not all errors were detected or reported. Furthermore, staff reception of the error reporting system could also affect the reporting rate.
医疗保健领域的信息技术系统，如放射学中的图像存档与通信系统（PACS），对生产可能会产生积极影响，但也存在质量受损的风险。PACS的广泛使用消除了放射科医生和技术人员之间先前的反馈回路。放射科医生不再就检查中发现的质量差异进行直接沟通，而是提交一份纸质的质量控制报告。基于网络的问题报告工具可以帮助恢复部分反馈回路，还能为更详细地分析所提交的错误提供可能。本研究的目的是评估这样一个假设，即使用在线错误报告软件进行质量控制所获得的数据能够集中我们科室内部的工作重点。在为期6个月的研究期间所进行的372,258次放射检查中，共提交了930个错误（390个检查方案、390个检查验证和150个检查技术方面的错误），错误率为0.25%。在检查方案类别中，技术人员记录在超声检查中提交的错误数量最多（77个错误[44%]），而成像方案错误是计算机断层扫描模式中最高的亚型错误（35个错误[18%]）。在几乎所有模式中，定位和错误录入分别在检查技术和检查验证错误类别中具有最高的错误率。错误率低于1%可能意味着系统质量非常高；然而，更有可能的解释是并非所有错误都被检测到或报告了。此外，工作人员对错误报告系统的接受程度也可能影响报告率。
