Audit Title: Peer Review- Using Double Reporting As A Tool For Revalidation
Descriptor: An audit of double reporting by peer review for the purposes of appraisal and revalidation.
The process of Medical Recertification requires a doctor’s performance to be assessed in as objective a way as possible. Double reporting can be used as one of the tools to provide evidence to support an individual’s recertification portfolio, by providing evidence of reflective practice. This audit suggests a framework whereby the individual radiologist can use double reporting in a fair, and objective manner.
There is significant debate about how the accuracy of diagnostic tests should be calculated and reported in the literature. (1,2) There are no objective benchmarks for acceptable levels of observation or interpretation and ambiguity errors. (2,3) Therefore standards relating to the process are suggested.
1. An exercise in double reporting should be performed annually as part of Appraisal/Revalidation.
2. Level 2 and 3 discrepancies should be referred to the local discrepancy meeting. (4)
3. A summary detailing modality type, number of examinations and the grading results should be produced. This report and supporting proformas should be then part of the individual’s consultant annual portfolio and should be presented for the purposes of appraisal/revalidation (5)
100% for each of the above
A possible grading system is proposed which parallels the discrepancy meeting findings. 0 = no disagreement, 1 = minor disagreement, 2 = moderate disagreement, 3 = major disagreement. Grading of discrepancy eg. inconsequential; likelihood of change of management and harm to patient will allow an assesssment of impact in addition to frequency.
LOCAL PRACTICE WAS ASSESSED AS FOLLOWS
SUGGESTIONS FOR CHANGE IF TARGET NOT MET
The Resources Used …
THE DATA was collected by ...
˙ Computer records ˙ Review of requests ˙ Other (specify)
˙ Review of images ˙ Ongoing data recording
˙ Review of reports ˙ Questionnaire
˙ None ˙ Data analysis ˙ Other (specify)
˙ Secretarial ˙ Software (off shelf)
˙ Audit office ˙ Software (customised)
˙ Medical records ˙ Clinical professionals
TIME to help complete stages 1–3 of the first cycle
R A D I O L O G I S T R A D I O G R A P H E R O T H E R ( s p e c i f y )
Approx _____ hrs per week Approx _____ hrs per week Approx _____ hrs per week
for _____ weeks for _____ weeks for _____ weeks
= total _____ hours = total _____ hours = total _____ hours
COSTS (stages 1–3 of the cycle) apart from radiologists’ / radiographers’ time
˙ None/minimal ˙ Other (specify) Stages 1–3 of the first cycle
˙ Information technology
Results of the Completed Cycle…
Comparison of findings …
(a) with the standard, shows that ...
(b) with the previous audit findings, shows that ...
(c) indicates that an improvement on the previous audit findings has occurred ˙ Yes ˙ No
A Further Audit will Occur …
in months to start (date)
Useful References …
1.Peer review: Guidance on the use of double reporting RCR 2010
2. Standards for Reporting of Diagnostic Accuracy (STARD)
3. Soffa DJ, Lewis RS, Sunshine JH, Bhargavan M. Disagreement in interpretation: a method for the development of benchmarks for quality assurance in imaging. J Am Coll Radiol 2004; 1: 212–217.
4. Standards for the Reporting and Interpretation of Imaging Investigations. London: The Royal College of Radiologists, 2006. http://www.rcr.ac.uk/docs/radiology/pdf/standardsforreportingandinetrpwebvers.pdf
5. Standards for Radiology Discrepancy Meetings. London: The Royal College of Radiologists, 2007http://www.rcr.ac.uk/docs/radiology/pdf/stand_radiol_discrepancy.pdf
6. Standards for Self Assessment of Performance. London: The Royal College of Radiologists,2007 http://www.rcr.ac.uk/docs/radiology/pdf/stand_self_assess.pdf
The Audit was carried out by …
Stages 1–4 Stages 5–6
Address Telephone No:
A Copy of this form has been …
˙ placed in the Department’s Audit File
˙ sent to the Hospital’s Audit Office
˙ sent to the Clinical Audit Unit at the RCR
Further information (audit design / questionnaire / analysis of results / introduction of change)
is included as follows ...
© The Royal College of Radiologists 2014