Peer review in MRI: A quality improvement programme and pilot study
1University Hospital Ayr, UK.
Introduction:
The aim of this pilot study was to implement a peer review programme to evaluate MRI images and protocols, with the goal of improving quality and standardising protocols.
Method:
A plan-do-check-act method of action research was adopted. A checklist was designed and two radiographers scored the images (Optimal, Diagnostic or Suboptimal). A sample of five Lumbar Spine examinations were selected and reviewed on two separate occasions, one month apart. A consultant radiologist also scored the selected examinations.
Results:
There was excellent intra-rater reliability for both observers. At first assessment, Cohen's weighted Kappa analysis indicated moderate inter-rater agreement (0.457) rising to substantial agreement (0.606) at second assessment. Variations in sequence parameter settings by the radiographers were noted. Feedback via educational sessions were implemented and enhancement of protocols were made.
Conclusions:
Radiographers manipulate many parameters during MRI examinations, and image quality can be degraded if sequences are not optimised. This may lead to misinterpretation. Initial results suggest peer review can result in improved image quality, better protocols, and improved staff confidence. There are opportunity costs involved in releasing staff from clinical work and time and resources required for image appraisal training, however we suggest this model can be extended to other departments and modalities as a healthcare improvement initiative.
Implications For Practice:
Initial results suggest peer review processes performed by radiographers can result in improvement to protocols and image quality in MRI. With appropriate training, radiographers can implement and undertake appraisal of image quality in MRI as part of clinical governance. The purpose of feedback must be made clear, and good professional relationships should be forged to allow candid and supportive feedback with a focus on development and education.
Insights
Implementing radiographer-led peer review for MRI scans improved image quality and protocols. This quality improvement initiative enhanced staff confidence and can be extended to other imaging departments.
Area of Science:
- Radiology
- Medical Imaging
- Quality Improvement
Background:
- Magnetic Resonance Imaging (MRI) sequence optimization is crucial for image quality.
- Suboptimal protocols can lead to diagnostic errors and misinterpretations.
Purpose of the Study:
- To implement and evaluate a peer review program for MRI images and protocols.
- To enhance MRI image quality and standardize imaging protocols.
Main Methods:
- A plan-do-check-act methodology was employed.
- Radiographers used a checklist to score MRI images (Optimal, Diagnostic, Suboptimal).
- Five Lumbar Spine MRI examinations were reviewed twice by two radiographers and a consultant radiologist.
Main Results:
- Excellent intra-rater reliability was observed for both radiographers.
- Inter-rater agreement improved from moderate (0.457) to substantial (0.606) after the first assessment.
- Variations in sequence parameters were identified, leading to protocol enhancements via educational feedback.
Conclusions:
- Radiographer-led peer review shows promise in improving MRI protocols and image quality.
- This model can be adapted for clinical governance and healthcare improvement initiatives in other departments.
- Effective peer review requires clear feedback objectives and strong professional relationships for development.
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