Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow

Abstract

Purpose

To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria.

Methods

Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting.

Results

The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001.

Conclusion

The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well.

Key points

• Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals.

• A clinical cancer network provides opportunities to improve healthcare.

• Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality.

• Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement.