Radiology Peer Review

Steven J. Baccei MD Assistant Professor Vice-Chair of Quality, Patient Safety, and Process Improvement

The Department of Radiology has undertaken a Peer Review process for interventional radiology cases. Recently an article was published about the project in Radiology Business, some extracts from this article written by Caitlin Wilson are below. A paper was published in the Journal of the American College of Radiology entitled "How to Effectively Implement a Peer Review Process for Interventional Radiology Procedures," authors Michael Caruso, DO, Cole DiRoberto, BA, John Howe Jr, AAS, RT(R)(CT)(MR)(CIIP) and Steven J. Baccei, MD.

Extract from Radiology Business:

Peer review is a method doctors and health researchers use to hold the work of their whole industries accountable, including within the field of diagnostic radiology. But most interventional radiology practices don’t have similar standardized processes with which to verify work among radiologists.

In that absence, the interventional radiology department at UMass Memorial Medical Center was looking for a way to mimic its existing monthly morbidity and mortality meetings more frequently and formally.

“During those discussions, the section chief of interventional radiology [Stephen Wicky Van Doyer, MD] said ‘Maybe we could benefit from more formal type review, a more systematic review of our procedures. Maybe getting more of them in and also having them randomly chosen.’ That was the initial impetus behind it,” said UMass Interventional Radiology Vice Chair of Quality, Patient Safety and Process Improvement, Steven Baccei, MD.

Baccei and others from the department started creating a program to allow for intradepartmental reviews of each other’s cases. The program, known as Conserus, was modeled on the RADPEER system from the American College of Radiology (ACR) and then written to work within the existing radiological review system at UMass.

Every week, vascular interventional and neurointerventional radiologists are assigned three colleagues' cases to review. They answer a three-step questionnaire and rank their agreement with the findings/techniques/reporting of the cases as “yes, completely,” “yes, partially,” “no,” “unsure, not enough information,” or “not applicable.”

Baccei said the process has been “positive” and has revealed previously unseen trends within the department, opening the door for possible improvements such as less variability among case reports and discussions about imaging quality.

“It has really fostered a review of existing policies, and people as a result have been more aware of them formally. And we’ve reviewed some of the policies related to interventional radiology as a result of this,” Baccei said.  

The ultimate beneficiaries of this new practice are patients at UMass, according to Baccei. Having better-informed and better-prepared radiologists means their procedures will be more successful, he said.

“Having proceduralists talking about these things, reviewing cases systematically… ultimately what we’re hoping for is that patients will benefit and their procedures will go [more smoothly],” Baccei said.

Read the full Business Radiology article.

Paper in Journal of the American College of Radiology