Radiologist Opinions of a Quality Assurance Program: The Interaction Between Error, Emotion, and Preventative Action

Rationale and Objectives: To investigate inter-relationships between radiologist opinions of a quality assurance (QA) program, QA Committee communications, negative emotions, self-identified risk factors, and preventive actions taken following major errors. Materials and Methods: A 48 question electronic survey was distributed to all 431 radiologists within the same teleradiology organization between June 15 and July 3, 2018. Two reminders were sent during the survey time period. Descriptive statistics were generated, and comparisons were made with Fisher exact test. Significance level was set at p < 0.05. Results: Response rate was 67.5% (291/431), and 72.5% of respondents completed all survey questions. A total of 64.3% of respondents were male, and the highest proportion of radiologists (28.9%, 187/291) had been in practice >20 years. Preventative actions following an error were positively correlated to a higher opinion of the QA process, self-identification of personal risk factors for error, and greater negative emotions following an error (all p < 0.05). A higher opinion of communications with the QA committee was associated with a positive opinion of the QA process (p < 0.001). An inverse relationship existed between negative emotion and opinion of QA committee communications (p < 0.05) and negative emotion and opinion of the QA process (p < 0.05). Radiologist gender and full time versus part time status had a significant effect on perception of the QA process (p < 0.05). Conclusion: Radiologist opinions of their institutional QA process was related to the number of negative emotions experienced and preventative actions taken following major errors. Nurturing trust and incorporating more positive feedback in the QA process may improve interactions with QA Committees and mitigate future errors.