H. Benjamin Harvey MD, JD, Presenter: Nothing to Disclose

Tarik K. Alkasab MD, PhD, Abstract Co-Author: Nothing to Disclose

Sergio Andres Segrera, Abstract Co-Author: Nothing to Disclose

Daniel Ira Rosenthal MD, Abstract Co-Author: Nothing to Disclose

G. Scott Gazelle MD, PhD, Abstract Co-Author: Consultant, General Electric Company Consultant, Marval Biosciences Inc

Our department developed consensus-oriented group review (COGR), a software-enabled, peer review process in which groups of radiologists meet regularly to review randomly selected cases and record consensus on the acceptability of the issued reports. Designed around departmental teaching conferences, COGR is intended to foster the educational, peer coaching, and systems improvement aims of peer review. We study the peer review data collected after one year of performing COGR in our large academic radiology department.

Data of all cases undergoing COGR from October 2011 through October 2012 were exported into Microsoft Excel using the COGR software tool. The data was analyzed to determine the percentage of cases undergoing COGR review in accredited modalities (e.g. CT, MRI, U/S, mammography) and the rates of discrepancy and non-consensus. Additionally, all cases resulting in a consensus that the report should change (i.e. discrepant cases) were analyzed in greater detail to identify and categorize the source of the error/discrepancy.

From October 2011 through October 2012, 7,609 cases were reviewed with COGR in 1,541 conferences. Across all divisions, 2.0% of exams in accredited modalities were reviewed by COGR. The average radiologist participated in 55 COGR conferences. A total of 156 of reviewed cases (2.1%) resulted in a consensus that the report should change and 92 cases (1.2%) resulted in no consensus. For the discrepant cases, sources of error/discrepancy could be attributed to a dictation error in 20% of cases, omitted finding in 52% of cases, interpretative error in 19% of cases, failure to use non-routine communication of results in 1% of cases, and error related to a recommendation in 8% of cases.

Ongoing application of the COGR process generates highly contextualized peer review data that elucidates sources of error in diagnostic imaging. Sustained use in our department permits review of sufficient cases to comply with external standards for ongoing performance review while generating opportunities to identify issues and monitor progress towards quality goals.

Consensus oriented group review is a feasible and sustainable option for radiology peer review in a large academic medical center where it produces highly contextualized quality and saftey data.

Harvey, H, Alkasab, T, Segrera, S, Rosenthal, D, Gazelle, G, Consensus Oriented Group Review: Analysis of the First Year of Peer Review Data.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13024322.html