Transition From Peer Review to Peer Learning: Experience in a Radiology Department

To describe the process by which a radiology department moved from peer review to peer collaborative improvement (PCI) and review data from the first 16 months of the PCI process.

Data from the first 16 months after PCI were reviewed: number of case reviews performed, number of learning opportunities identified, percentage yield of learning opportunities identified, type of learning opportunities identified, and comparison of the previous parameters between case randomly reviewed versus actively pushed (issues actively identified and entered). Changes in actively pushed cases were also assessed as volume per month over the 16 months (run chart). Faculty members were surveyed about their perception of the conversion to PCI.

In all, 12,197 cases were peer reviewed, yielding 1,140 learning opportunities (9.34%). The most common types of learning opportunities for all reviewed cases included perception (5.1%) and reporting (1.9%). The yield of learning opportunities from actively pushed cases was 96.3% compared with 3.88% for randomly reviewed cases. The number of actively pushed cases per month increased over the course of the period and established two new confidence intervals. The faculty survey revealed that the faculty perceived the new PCI process as positive, nonpunitive, and focused on improvement.

The study demonstrates that a switch to PCI is perceived as nonpunitive and associated with increased radiologist submission of learning opportunities. Active entering of identified learning opportunities had a greater yield and perceived value, compared with random review of cases.