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Volume 21, Issue 5 , Pages 617-625 , May 2010

Guidelines for Establishing a Quality Improvement Program in Interventional Radiology

Joseph R. Steele, MD
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
- Address correspondence to J.R.S., c/o Debbie Katsarelis, SIR, 3975 Fair Ridge Dr, Suite 400 N., Fairfax, VA 22033
Michael J. Wallace, MD
- Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
David M. Hovsepian, MD
- Department of Radiology, Stanford University, Palo Alto, California
Brent C. James, MD, MStat
- Intermountain Institute for Health Care Delivery Research, Salt Lake City, Utah
Sanjoy Kundu, MD
- Department of Medical Imaging, Scarborough General Hospital, Richmond Hill, Ontario, Canada
Donald L. Miller, MD
- Department of Radiology, National Naval Medical Center, Uniformed Services University, Bethesda, Maryland
Steven C. Rose, MD
- Department of Radiology, University of California San Diego Medical Center, San Diego, California
David Sacks, MD
- Department of Interventional Radiology, The Reading Hospital and Medical Center, West Reading, Pennsylvania
Samir S. Shah, MD
- Division of Vascular and Interventional Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania
John F. Cardella, MD
- Department of Radiology, Geisinger Health System, Danville, Pennsylvania

Received 11 December 2009 ,Revised 4 January 2010 ,Accepted 13 January 2010.

(a) Diagram of changes associated with a quality assurance program wherein a threshold (quality tail) is used to identify outliers. In this situation there is not significant change in the mean perfor

(a) Diagram of changes associated with a quality assurance program wherein a threshold (quality tail) is used to identify outliers. In this situation there is not significant change in the mean performance. (b) Changes associated with a quality improvement program wherein the emphasis is on a significant shift in mean performance (quality shift).
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Flowchart of movement of an emergency room patient with a possible stroke through initial clinical and imaging evaluation. Four subprocesses are identified, and four corresponding metrics are created.

Flowchart of movement of an emergency room patient with a possible stroke through initial clinical and imaging evaluation. Four subprocesses are identified, and four corresponding metrics are created. Because avoidance of delays is critical to good outcome of patients with stroke, the metrics were defined as time required to complete each process. (Available in color online at www.jvir.org.)
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Run chart showing data from a continuous quality improvement study of the transport time for patients from the emergency room to the CT imaging unit (metric 2 in Fig 2). (Available in color online at

Run chart showing data from a continuous quality improvement study of the transport time for patients from the emergency room to the CT imaging unit (metric 2 in Fig 2). (Available in color online at www.jvir.org.)
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Run chart showing data from a CQI study of the transport time for patients from the emergency room to the CT imaging unit (metric 2 in Fig 2). Addition of a second transporter on day 14 resulted in de

Run chart showing data from a CQI study of the transport time for patients from the emergency room to the CT imaging unit (metric 2 in Fig 2). Addition of a second transporter on day 14 resulted in decreased transport time. (Available in color online at www.jvir.org.)
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