Radiology Patient Outcome Measures: Impact of a Departmental Pay-for-Performance Initiative on Key Quality and Safety Measures
| Autor: | Wenhong W. Mar, Ramin Khorasani, Giles W. Boland, Pragya A. Dang, Sheila S. Enamandram, Kristine S. Burk, Cynthia Centerbar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percentile Intranet business.industry Dashboard (business) Pay for performance Statistical process control Subspecialty Radiography Patient safety Radiologists Medicine Humans Radiology Nuclear Medicine and imaging Radiology Prospective Studies business Prospective cohort study Reimbursement Incentive |
| Zdroj: | Journal of the American College of Radiology : JACR. 18(7) |
| ISSN: | 1558-349X |
| Popis: | Assess impact of a multifaceted pay-for-performance (PFP) initiative on radiologists' behavior regarding key quality and safety measures.This institutional review board-approved prospective study was performed at a large, 12-division urban academic radiology department. Radiology patient outcome measures were implemented October 1, 2017, measuring report signature timeliness, critical results communication, and generation of peer-learning communications between radiologists. Subspecialty division-wide and individual radiologist targets were specified, performance was transparently communicated on an intranet dashboard updated daily, and performance was financially incentivized (5% of salary) quarterly. We compared outcomes 12 months pre- versus 12 months post-PFP implementation. Primary outcome was monthly 90th percentile time from scan completion to final report signature (CtoF). Secondary outcomes were percentage timely closed-loop communication of critical results and number of division-wide peer-learning communications. Statistical process control analysis and parallel coordinates charts were used to assess for temporal trends.In all, 144 radiologists generated 1,255,771 reports (613,273 pre-PFP) during the study period. Monthly 90th percentile CtoF exhibited an absolute decrease of 4.4 hours (from 21.1 to 16.7 hours) and a 20.9% relative decrease post-PFP. Statistical process control analysis demonstrated significant decreases in 90th percentile CtoF post-PFP, sustained throughout the study period (P.003). Between 95% (119 of 125, July 1, 2018, to September 30, 2018) and 98.4% (126 of 128, October 1, 2017, to December 31, 2017) of radiologists achieved90% timely closure of critical alerts; all divisions exceeded the target of 90 peer-learning communications each quarter (range: 97-472) after January 1, 2018.Implementation of a multifaceted PFP initiative using well-defined radiology patient outcome measures correlated with measurable improvements in radiologist behavior regarding key quality and safety parameters. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|