Lecture 7: Using structured reports to reduce errors
Goal: Understand how structured reports can be used to reduce diagnostic errors
Objectives
- Define structured reporting
- Discuss the benefits of structured reporting
- List common pitfalls of structured reporting
- Explain strategies for implementing structured reporting
Recommended reading
Lecture 7 Pretest
A report that contains common reporting headings (e.g. “Indication; Findings; Impression, etc), subheadings within the Findings section, and a standardized lexicon is a _________ structured report.
- Tier 1
- Tier 2
- Tier 3
- Tier 4
An advantage of structured reporting is that it prompts radiologists to continue inspecting anatomic regions on the images whether or not the radiologist has already made a pertinent diagnosis. In so doing, structured reporting mitigates against:
- Anchoring bias
- Alliterative bias
- Satisfaction of search bias
- Framing bias
“Contextual reporting” is a form of structured reporting where:
- The report template is tailored to the clinical indication or diagnosis in question
- Each report subheading includes pre-populated drop-down menus
- Free-text reporting is always permitted
- Date and time of report creation are incorporated into the report
A potential pitfall of structured reporting is:
- Increases syntactic errors in reports
- Reduces reimbursement by rigid documentation of imaging technique and findings
- Reduces radiologist “dwell time” on the images by increasing their focus on filling out the report template
- Promotes “satisfaction of search”tendency among radiologists
When implementing structured reporting templates, it is recommended to:
- Use financial incentives to encourage adherence with structured reporting
- Create reporting templates that prioritize efficiency and reimbursement
- Tailor templates to specific clinical presentations or diagnoses
- Develop report templates among a select group of subspecialist radiologists
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