Cole DiRoberto on Quality, Patient Safety and Process Improvement

Radiology Quality, Patient Safety and Process Improvement at UMass has been growing rapidly under the leadership of Vice-Chair, Dr. Steven Baccei. This growth has recently opened doors for Cole DiRoberto, a 2015 graduate from Bowdoin College in Maine, who is interning with Dr. Baccei as a research assistant for the next year. While at Bowdoin College, Cole studied Mathematics and Economics while on the pre-med track, in hopes of being accepted to medical school after his internship at UMass.

Only just beginning in August, Cole is already deep into his first project and explains the process with great enthusiasm. Cole says, “We’re in the middle of a quality improvement project analyzing the degree to which RIS-IC order indications match their corresponding clinical order indications. We’ve categorized these pairings into those that are “perfectly concordant,” “partially concordant,” and “discordant.” Essentially, we are hoping to uncover exactly how well the indications match up and how well the system that we currently have in place is performing.  Our key findings include only a 45.4% rate of perfect concordance. Therefore, more than half of the time the RIS-IC indication is incomplete or does not match the clinical order. The most common problem is that the RIS-IC indication is terse, often leaving out key information such as sidedness of an injury or the specific location of the problem. Another issue we looked at was the presence of grammatical errors in the RIS-IC indications. We found that there are actually more grammatical errors (555) than indications that we used in our data (500). These errors are due to improper capitalization, abbreviations, misspelling, and misplaced punctuation. Only 49 out of the 500 indication pairs were perfect matches that also included the complete history of the patient’s issue and were free of grammatical errors (9.8% rate). The end goal is to create a system that avoids these errors and achieves a perfect rate of correspondence between RIS-IC to clinical order indication in order. In this way, we will increase patient safety and eliminate inaccuracies and inefficiencies.” Dr. Baccei and Cole’s partnership in this study will result in a published paper by the end of the year-long internship.

In addition to this project, Dr. Baccei, Cole, Dr. Karen Johnson, and Sarah Saliba of the IRB are collaborating to create a streamlined radiology template that will facilitate the initiation of more research projects involving retrospective patient data analysis.