Building a Culture of Quality Improvement

Richard E. Sharpe Jr., MD, MBA, Member of the American College of Radiology^® (ACR^®) Peer Learning Committee and Assistant Professor of Radiology, Consultant and Division Chair of Breast Imaging in the Department of Radiology at Mayo Clinic, contributed this piece.

The effectiveness of a radiology quality and patient safety program is enhanced by an ongoing understanding of prevailing errors. Many tools are available to assist in analyzing errors and understanding their cause, but this understanding cannot happen unless errors are revealed in the first place and supported by a culture of continuous quality improvement, avoiding blame and focusing instead on error prevention.

Peer learning is an alternative approach to score-based peer review that asks radiologists to identify and discuss learning opportunities from their case mix and use those discussions to improve their processes. By identifying and discussing learning opportunities from clinical practice, peer learning programs align with imperatives of the Institute of Medicine to improve the quality of patient care and build a culture of safety.

A national survey conducted by the ACR Peer Learning Committee finds that peer learning has grown from a small movement of quality enthusiasts to being widely adopted across the United States, with more than half of respondents already using peer learning. The survey also demonstrates that radiologists who are not yet involved in peer learning are eager to adopt such a program. Participants describe their programs as having improved upon the limitations of score-based peer review, aligned with emerging quality principles and an endeavor they highly recommend to colleagues.

Peer learning has especially gained traction in urban and academic practices, as well as among younger and female radiologists. The widespread adoption is encouraging for patients receiving imaging care and for practicing radiologists seeking to further hone their craft. Thanks to the work of the committee, quality peer learning is recognized as equivalent to scored-peer review with all major accrediting boards.

The ACR Peer Learning Committee is committed to helping practicing radiologists implement and develop their peer learning programs. The Committee has created a variety of resources designed to help people understand what peer learning is, and also with easy-to-follow step-by-step guides to implementation. Resources include webinars, publications, customizable presentation templates, toolkits and learning guides. In addition, we invite you view our Peer Learning Webinar recording learn more about how to develop a peer learning program and overcome challenges along the way.

If practices have further questions or need help, please contact peerlearning@acr.org for personalized assistance, and stay tuned to acr.org for future updates and resources.