Feedback Conversion

Once sent to QMS, radiologist feedback records are displayed in the Staged Feedback list on the Home tab of the dashboard.  The Accession number of each record in the Staged Feedback list serves as a link to the Add/Edit Detraction interface.  The images below show the location of the Staged Feedback List and the Add/Edit Detraction Interface.

Within the Add/Edit Detraction interface, the quality manager converts feedback records into quality detraction records.  This process effectively converts the qualitative feedback into quantitative data useful for statistical analysis.  This is a five step process:

1. Select the Detraction Type.
2. Select the Severity of the detraction.
3. Indicate the Source of the feedback.
4. Distribute Fault for the detraction.
5. Add Notes related to the detraction.

These steps are completed using the controls illustrated in the gallery of images below:

Select Detraction Type

The first step is to select a Detraction Type that characterizes the nature of the feedback.  This adds a powerful dimension to the data in that it enables us to formulate, analyze, and track ratings based upon the detraction type (See QAISys Method> Data Analysis and Tracking).

Select Severity

The second step is to select the Severity of the detraction.  The quality manager may select Slight, Moderate, or Severe.  This step determines the amount of Dissatisfaction Value (DV) that is assigned to the exam in the detraction record.  The DV is a numeric value that serves as a core component in the construction of QRs (quality/QAISys^® ratings) (See QAISys Method> Ratings Formulation).  Slight detractions contribute 0.5 DV, Moderate detractions contribute 1 DV, and Severe detractions contribute 3 DV.[*]

Indicate Source

The third step is to indicate the Source of the feedback.  This is usually the interpreting radiologist but it could be a different source such as a referring physician, a patient survey, or a quality manager.  Often this information has already been included in the feedback record and the appropriate selection is shown in the field.

Distribute Fault

The fourth step is to distribute Fault for the detraction between the four possible sources.  This step allows a more complete accounting of the events causing the detraction.  If the manager changes the Fault Distribution away from the default settings for the selected detraction type, QMS requires the manager to document the reason for the change in the Follow-up Notes.

Add Exam Follow-up Notes

The fifth step is to add notes related to the detraction.  As mentioned previously, entry of notes into this field is required whenever Severity or Fault Distribution deviates from the default settings, but the quality manager may also add miscellaneous notes to this field as desired.

To illustrate this process, suppose radiologist feedback for an exam indicates that motion artifact has degraded the image quality significantly and the technologist has indicated in the exam history that the patient has Parkinson’s disease.  The quality manager is able to shift Fault away from the Technologist and onto the Patient as the source of the quality detraction.  This affects Ratings Formulation because it determines what portion of the DV is associated with each source.  In the example, the quality manager would select Motion Artifact as the detraction type.  The default Severity is Moderate, but the quality manager would increase this by selecting Severe since the feedback indicates that motion artifact has degraded the image quality significantly.  The default Fault Distribution for Motion Artifact is 75% attributed to the Technologist and 25% attributed to the Patient.  The quality manager could shift Fault for the detraction by 25% away from the Technologist and toward the Patient since the Technologist recognized the quality deficiency and documented that the patient has Parkinson’s.  The manager could further increase the shift of fault away from the Technologist and onto the Patient if the Technologist had documented efforts to reduce motion artifact by decreasing exposure time, utilizing immobilization aids, or obtaining assistance from another tech.[†]

Under other circumstances, Fault for the detraction might be shifted away from the Technologist to Equipment failure or Process deficiency.[‡]