Improving ACRs: Standardized report cards

Apply consistent metrics and feedback to improve abnormal call rates

icon standardized report cardsStandardized report cards help individual radiologists understand their performance and how it compares to that of their peers. Using report cards that track a set of standard metrics, radiologists can identify areas for improvement and determine the steps they need to take to hit their targets.

What standardized report cards look like in practice

Standardized feedback can make a real difference. One Canadian provincial screening program reported a reduction in abnormal call rates from 9% to 6% after confidential feedback and radiologist report cards were introduced.

There are many ways to create and use standardized report cards. The United Kingdom, for example, has a quadrant-based reporting system that provides recommendations to help radiologists move to higher quadrants.

In Canada, Ontario Health and the College of Physicians and Surgeons of Ontario have developed a similar mechanism. British Columbia and Quebec are already using some elements of this system, and a number of other provinces use various forms of standardized feedback and reporting to measure radiologist performance.

How to put this approach into action

Following these steps will help breast cancer screening programs implement this approach:

  1. Create standardized report cards for all radiologists with a consistent set of metrics (e.g., cancer detection rate, positive predicted values, false positives, reading volumes, abnormal call rate).
  2. Based on their scores, assign radiologists specific short- and long-term goals, with guidance on how to achieve them.
  3. Hold mandatory follow-ups with radiologists whose performance is below the desired level to discuss improvement strategies.

What is needed to succeed

  • Timely and up-to-date data
  • Clear goals and timelines
  • Clear performance comparisons among programs, provinces, etc.
  • Radiologist feedback to improve templates

Challenges to overcome

  • Cost
  • Radiologist motivation and engagement

More approaches on improving abnormal call rates in breast cancer screening with mammography

Learn more about peer review and mentorship, education, minimum reading volumes, batch reading and double reading.