Breast Imaging Fellowship Program Director, Department of Radiology, Stanford University School of Medicine, Stanford, California; Physician Leader, Mammography Positioning Improvement Collaborative, American College of Radiology Learning Network.
Senior Quality Programs Specialist, ACR, Reston, Virginia.
J Am Coll Radiol. 2024 Nov;21(11):1755-1764. doi: 10.1016/j.jacr.2024.06.013. Epub 2024 Jun 29.
PURPOSE/OBJECTIVE: To share the experience and results of the first cohort of the ACR Mammography Positioning Improvement Collaborative, in which participating sites aimed to increase the mean percentage of screening mammograms meeting the established positioning criteria to 85% or greater and show at least modest evidence of improvement at each site by the end of the improvement program.
The sites comprising the first cohort of the collaborative were selected on the basis of strength of local leadership support, intra-organizational relationships, access to data and analytic support, and experience with quality improvement initiatives. During the improvement program, participating sites organized their teams, developed goals, gathered data, evaluated their current state, identified key drivers and root causes of their problems, and developed and tested interventions. A standardized image quality scoring system was also established. The impact of the interventions implemented at each site was assessed by tracking the percentage of screening mammograms meeting overall passing criteria over time.
Six organizations were selected to participate as the first cohort, beginning with participation in the improvement program. Interventions developed and implemented at each site during the program resulted in improvement in the average percentage of screening mammograms meeting overall passing criteria per week from a collaborative mean of 51% to 86%, with four of six sites meeting or exceeding the target mean performance of 85% by the end of the improvement program. Afterward, all respondents to the postprogram survey indicated that the program was a positive experience.
Using a structured improvement program within a learning network framework, the first cohort of the collaborative demonstrated that improvement in mammography positioning performance can be achieved at multiple sites simultaneously and validated the hypothesis that local sites' shared experiences, insights, and learnings would not only improve performance but would also build a community of improvers collaborating to create the best experience for technologists, staff, and patients.
目的/目标：分享 ACR 乳腺摄影定位改进合作的第一批队列的经验和结果，其中参与的站点旨在将符合既定定位标准的筛查乳腺 X 光检查的平均百分比提高到 85%或更高，并在改进计划结束时在每个站点至少显示出适度的改进证据。
合作的第一批队列中的站点是根据当地领导支持、组织内部关系、获取数据和分析支持以及质量改进计划经验的实力选择的。在改进计划期间，参与的站点组织了他们的团队，制定了目标，收集了数据，评估了他们的现状，确定了他们问题的关键驱动因素和根本原因，并开发和测试了干预措施。还建立了标准化的图像质量评分系统。通过跟踪每个站点实施的干预措施对符合总体通过标准的筛查乳腺 X 光检查的百分比随时间的变化，评估了每个站点实施的干预措施的影响。
六个组织被选为第一批参与，从参与改进计划开始。在计划期间，每个站点开发和实施的干预措施导致每周符合总体通过标准的筛查乳腺 X 光检查的平均百分比从合作的 51%提高到 86%，其中六个站点中的四个在改进计划结束时达到或超过 85%的目标平均绩效。之后，对方案后调查的所有回复者都表示该方案是一次积极的体验。
在学习网络框架内使用结构化的改进计划，合作的第一批队列表明，多个站点的乳腺摄影定位性能可以同时得到改进，并验证了以下假设，即当地站点的共享经验、见解和学习不仅会提高绩效，还会建立一个改进者社区，共同努力为技术人员、员工和患者创造最佳体验。
