Quality improvement has taken center stage in diagnostic radiology residency programs, as the Accreditation Council for Graduate Medical Education now requires experience with quality improvement during residency. Four types of quality improvement projects may be particularly appropriate for residents, according to an article published online Feb. 18 in the Journal of American College of Radiology.

“It is important to recognize that a solely didactic-based quality education program is not effective,” wrote C. Matthew Hawkins, MD, of the department of radiology at University of Cincinnati, and Paul Nagy, PhD, of the department of radiology at Johns Hopkins University in Baltimore.

Although residents face challenges in the design and implementation of quality improvement projects, experience leading a quality improvement project can identify a physician as one who understands the broader role of radiology in healthcare. In addition, a resident can demonstrate his or her commitment to skills that help avoid commoditization of radiology, according to Hawkins and Nagy.

The authors suggested four specific types of quality improvement projects as particularly suited to the demands and constraints of radiology residency programs. These are:

• Implementing appropriateness criteria—a resident could select one of the American College of Radiology’s 180 topics and design an initiative to improve utilization of the criterion;
• Knowing the clinical history—a resident could identify a particular piece of the patient’s clinical history that could be included with a specific imaging exam to aid interpretation of the exam and compare baseline provision with post-intervention provision of the data;
• Using checklists—a resident could measure steps involved in an imaging process, such as fluoroscopy, and develop and apply a checklist with the goal of improving safety and/or efficiency; and
• Acting as an ambassador—a resident could devise an imaging ambassador rotation and attend medicine or surgery rounds for two weeks with trainees to answer questions, interact with patients and learn about end-user interaction with radiology systems.