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PQI - Use of Practice Performance Guidelines and Technical Standards. Practice Guidelines & Technical Standards. ABR requirement. Use of ACR communication guideline and one other to evaluate individual practice Why use ACR guidelines? National standard
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PQI - Use of Practice Performance Guidelines and Technical Standards
ABR requirement • Use of ACR communication guideline and one other to evaluate individual practice • Why use ACR guidelines? • National standard • Developed by consensus of large number of radiologists • Large number of guidelines/standards from which to choose (111 guidelines, 3 tech standards in DR)
How are these developed? • Guideline proposed by subspecialty society, member, state organization to specialty commission of ACR • Can accept, modify or reject • Sent to Quality and Safety Commission for review, revision • Composed of members of guidelines and standards committees of each of the 11 specialty commissions • Broad representation
Sent to BOC – can send back or accept • Sent to CSC, assigned to specific member • Available for 4 wks on website for comment • Mailed to councilors, alt councilors, state chapters • Committee composed of original writers, interested parties, CSC members reviews comments, revises • Assigned to reference committee
Annual meeting • Reference committee – all can comment, revised PRN • Placed on consent calendar • Revised q 5 years or sooner
Practice guideline vs. technical standard • Practice guideline – conduct in specific areas of practice • NOT legal standards • Technical standard - technical parameters that are quantifiable or measurable • meant to set minimal levels of technical performance
Communication Guidelines • Reports • Demographics • Clinical info • Body of report (including descrip of study, findings, limitations, comparison studies/reports • Impression (including specific dx, ddx, f/u studies, patient reaction) • Transmission to physician, provider re. state and federal requirements
Communication other than final report • Preliminary report • Non-routine communication • Findings needing immediate/urgent intervention • Discrepancies with prelim report • Serious, unexpected findings • Documentation • Methods – telephone, other • Informal communication
Self-referred or third party referred • Need to communicate with patient • Communication policy
Issues • How report? • Y/N • % • Essay • Compliance with one item or all • If one, suggest non-routine communication since it is key for patient safety • Last 100 reports, how many needed, how many documented.
Others: Detection of PE in adults • Indications, contraindications, risks to study • Qualifications and responsibilities of personnel • Specifications of exam • Pt considerations (hx) • Technical parameters • Minimum technical requirements • Scan interpretation (include quality of exam, use of med and lung windows)
Documentation • Equipment specifications • QI, safety, pt education
Issues • Much is practice, not individual based • ?? Other
What can SS do? • Suggest specific or group of guidelines • Keep database • What else? • What is your SS society doing in this arena?