If ever there was a case to be made for the importance of quality and patient care in radiology it is this one statistic: the real-time error rate in daily radiology practice is 3 to 5 percent, representing 40 million diagnostic errors annually worldwide.1 To make matters worse, the retrospective error rate in radiologic examinations is approximately 30 percent.2 In an environment where physicians are increasingly reliant on imaging for patient diagnosis and care plans, quality and patient care hang in the balance.
The good news is that diagnostic errors are preventable events, root causes can be readily identified, and real time solutions can be hardwired into department protocols and staff training.
However, administration must have the will, departments must have the budget, and staff must be engaged. Quality must be priority number one for every radiology department – and every radiologist.
As physicians and payers require more imaging to support diagnoses, radiologists are experiencing a steep workload with reduced support staff, rising quality expectations, and in some organizations, antiquated technology. This is increasing stress levels and burnout rates in radiologists, exacerbating an already risky environment with errors that occur all too frequently.
Medical errors and misreads can take different forms in radiology, including:
Several factors contribute to the occurrence of medical errors and misreads in radiology. Burnout, for example, can result in fatigue and decreased focus, leading to misreads or errors. Radiologists who specialize in a particular subspecialty or modality may not have enough exposure to other specialties, leading to potential errors when interpreting unfamiliar images. Additionally, staff members may be under pressure to read a high volume of imaging studies quickly, leading to errors or misreads.
Another contributing factor to misreads in radiology is the increasing demand for imaging studies. “The demand for imaging is outpacing what we’re doing on the training side,” said Dr. Vahid Yaghmai, professor and chair of radiological sciences at the University of California, Irvine. “The number of radiologists in the workforce is not growing as fast as the population and the demand for imaging.”3
There are not enough radiologists available to read these studies, and even if there are, they may not have the appropriate training in other subspecialties or modalities to handle the volume of imaging adequately. This situation can result in more misreads or errors due to the radiologist's lack of experience.
Given the myriad issues resulting in misreads and errors, how can patient care be improved? The answer is a methodical approach that assesses and addresses each issue proactively, combined with an action plan for immediate assessment of issues in real time.
Here’s how to address the issues raised above:
The bottom line is that everyone in an institution bears the responsibility of protecting and improving patient care. When it comes to the radiology department, their specific efforts must be supported by quality and risk, finance and administration. Just as “no man is an island”, no department functions completely alone.
Radiology must have robust support in order to deliver highly accurate interpretations and improved reporting quality. That means:
It could be said that every patient diagnosis begins with imaging and the interpretation of those images are the first milestone in the patient care pathway. Therefore, this essential function must be supported with training, trust, and empowered radiologists that feel free to share concerns and seek advanced training. When these tools are placed in the hands of the experts in the department, errors can be addressed, quality will improve, and patient care will be enhanced.
 Radiographics https://pubs.rsna.org/doi/10.1148/rg.2018180021
 American Journal of Roentgenology https://www.ajronline.org/doi/full/10.2214/AJR.12.10375#:~:text=Every%20radiologist%20worries%20about%20missing%20a%20diagnosis%20or,claims%20against%20radiologists%20are%20related%20to%20diagnostic%20errors
 Radiological Society of North America https://www.rsna.org/news/2022/may/Global-Radiologist-Shortage