Want to add value to your radiology practice? Add a quality control radiologist

Five years ago, researchers at the University of California, San Francisco, noticed a problem within their institution’s neuroradiology practice: residents on the graveyard shift were spending hours tied up on the phone with referring clinicians, while attending radiologists and technologists struggled to juggle a multitude of diverse and time-consuming tasks. “We realized that this practice was unpleasant and unsustainable, and an intervention was vital,” wrote Mark D. Mamlouk, MD, and his UCSF colleagues in a case study published online March 14 in the Journal of the American College of Radiology. That intervention consisted of the creation of a new position within the neuroradiology practice: a quality control (QC) radiologist. The newly designed role would include responsibilities of examination safety, protocoling, patient consultation, real-time scan monitoring and, perhaps most importantly, clinical consultations. “One of the main roles of the QC radiologist is to be available for discussion with referring providers and technologists who may have questions on examination appropriateness or how to order or tailor imaging studies,” the researchers wrote. Now, Mamlouk and his team say the effect of having a QC radiologist in the practice has been dramatic. “The change has revolutionized our operations. Not only are we better able to divide the workflow in our department, we have added value for our referring providers and patients according to the dimensions of patient care enumerated by the Institute of Medicine.” In a recent comprehensive survey of the practice’s faculty neurologists and technologists, 100 percent agreed that presence of the QC radiologist resulted in considerably fewer reading room interruptions. The same unanimous consensus believed that their ability to effectively teach residents and fellows is now considerably better since the installment of the QC. “From a technologist viewpoint, 80 percent felt that examination throughput was more efficient with a QC radiologist, and 80 percent thought that it was easier to contact a radiologist,” Mamlouk and his colleagues added. “These results, although qualitative, reflect the successful impact of our QC experience.”   That impact comes at a cost, however, and not every radiology practice can afford to add another position to their ranks—an issue the UCSF researchers believe may deter others from exploring the possibility of adding a QC radiologist. But the added value to practice workflow and patient care may be enough to warrant a change. “We understand … that the QC radiologist may not be plausible in all radiology sections and represents an expensive option,” wrote Mamlouk and his team. “However, the advantages of such a program can be offset by improved efficiency and public relations.”