New rad peer review process stresses consensus, rich feedback

Consensus-Oriented Group Review (COGR), a new model of radiology peer review, allows groups of radiologists to discuss current cases in a conference setting to reach consensus judgments about the appropriateness of the case under examination, according to an article published online Oct. 16 in the Journal of the American College of Radiology.

Tarik Alkasab, MD, of Boston’s Massachusetts General Hospital, and colleagues have revamped the peer review process for radiologists, an essential of comprehensive health care quality and safety.  They argued that RADPEER, the work-station system developed by the American College of Radiology, is comprised of many archaic characteristics including: a lack of timeliness, an inability to randomly select cases, a limited number of reviewers, lack of anonymity, and a disregard for other aspects of quality beyond interpretive errors.

Enter COGR, Alkasab and colleagues’ streamlined development for the peer review process. COGR allows for a group discussion of cases in a conference setting, placing greater emphasis on feedback than other traditional systems. COGR not only optimizes performance improvement, but fosters group standards of practice as well, according to the authors.

Radiologists, including the person under review, meet to look over a randomly selected sample of recent cases in a conference setting. The group views each report together with the aid of COGR’s software solution, trying to reach a consensus if any needs must be changed. Ultimately, all must agree upon the consensus. Review feedback occurs in real time, in person, and from peers. If need be, the radiologist under review immediately provides additional context and defends his or her report.

COGR balances feedback and values the review process itself, shifting away from solely identifying a case’s mistakes. Rather, the process aims to answer the question: Does this report need change? The system provides rich and highly contextualized feedback for radiologists, ultimately increasing the process’s transparency.

“The COGR process, when performed regularly, should allow sufficient cases to be reviewed to comply with external standards for ongoing performance review, while providing ample opportunities for groups to monitor and move toward internal quality goals,” wrote Alkasab and colleagues. “We also expect that COGR conferences will have benefits for participating groups beyond peer review, namely, fostering team building through goal-oriented group interactions.”