Continuous quality improvement process to track lost radiographs and reduce losses

To describe a quality improvement process that was initiated in a Department of Radiology to reduce the number of incomplete or "lost" imaging studies and decrease the time from the initiation of an imaging study to printing of the final report.

Incomplete cases were defined as those imaging studies that did not have a signed final report more than 3 days and less than 90 days after imaging. A computer program was written to generate a monthly incomplete case list from the radiology information system database; each step in the process, from patient arrival to final report printing, was analyzed and a list of root causes (for the incomplete cases) was developed. Short- and long-term interventions were introduced and the effects were monitored from 1992-1999.

Problems were identified at each step in the process. Although some of the root causes originated outside the authority of the Department of Radiology, interventions we implemented within the department reduced the incomplete list by 72%, from a high of 2.8% of all imaging examinations to less than 0.8%. Continual monitoring of the problem is necessary to maintain this level.

The number of incomplete or "lost" imaging studies can be decreased using a continuous quality improvement process. This leads to improved patient care and increased revenue.