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.

Background:

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.

 

The cycle:

THE STANDARD

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)

 

                              

National                                             Local

 

Target

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

 


ASSISTANCE

     ˙  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

£

 
     ˙  Temporary staff

                ˙   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
http://www.rcr.ac.uk/docs/radiology/pdf/BFCR(10)1_peer_review.pdf
2. Standards for Reporting of Diagnostic Accuracy (STARD)
http://bmj.com/cgi/reprint/326/7379/41.pdf
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

 

Hospital

 


Address                                                                    Telephone No:

 

 

 

 


                                                                                Fax 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

 

 

Appendix …

Further information (audit design / questionnaire / analysis of results / introduction of change)

is included as follows ...

 

 

 

 

 

 

 

 

 

© The Royal College of Radiologists 2014