Clinical governance improves the quality of nuclear medicine reporting

To assess the quality of nuclear medicine reporting, within a private UK hospital, of five physicians from four different National Health Service trusts and compare it with a similar previous clinical governance exercise.

Reports (n=140) were shown anonymously to all five physicians, including the one who produced the report. Each physician ranked them on a scale of 1-5, with 1 and 5 corresponding to complete disagreement and complete agreement, respectively. All reports with at least one score of <4 were subjected to consensus review by all five physicians and subsequently given a consensus score.

Six hundred and ninety-one audit opinions were present out of a possible 700 (98.7%). Forty-three reports were reviewed, of which 11 received a consensus score of <4 (7.9%). This is not significantly different from the proportion of nontrivial errors in our earlier study (10.2%). Only three reports were present, however, with a score of <3 (2.1%), significantly fewer (P<0.02) than the proportion of nontrivial errors in our earlier study. No scores of 1 were recorded. No reporter attracted significantly more scores of <4 compared with the overall proportion of such scores. A score given by an auditing physician which was 2 or more points different from the consensus score was defined as a suboptimal audit. Forty-four of 691 suboptimal audits (6.4%) were present, significantly fewer than the proportion of suboptimal audits in our earlier study (9.7%; P<0.03).

Studies such as these provide a useful framework for monitoring performance. This improved significantly in this study as compared with our previous audit.