title: Optimizing peer review: A year of experience after instituting a real-time comment-enhanced program at a children's hospital.
abstract: OBJECTIVE
  Peer review has become an essential component of a comprehensive radiology department quality assurance program. Multiple commercial programs, such as RADPEER, are available to fill this need but may be limited by low radiologist compliance and delayed or limited feedback. Consequently, these peer review programs may not achieve the greater goal of improving diagnostic quality. This article presents data from a peer review system implemented in an academic radiology group at a large urban multidisciplinary children's hospital. The peer review system offered instantaneous feedback with an enhanced comment feature for peer radiologists.
  
  
  METHODS
  Peer review data were collected on 5278 radiologic studies over a 12-month period including 15 radiologists. The data were analyzed for compliance rate, discrepancy rate, and comment usage.
  
  
  RESULTS
  The compliance rate for peer review averaged 52% for the 12-month period. The compliance rate trended upward over the course of the year, with a final month's compliance rate of 76%. The discrepancy rate between original interpretation and peer review was 3.6%. Comments were voluntarily included in 7.3% of nondiscrepant peer review scores.
  
  
  CONCLUSIONS
  Our peer review process was enhanced by real-time comment-enriched feedback on both discrepant and nondiscrepant peer reviews. We show improved radiologist compliance over the course of a year in a peer review program with no incentives or penalties for performing reviews. To our knowledge, no compliance rates exist in current literature for comparison.
authors.affiliation: Department of Radiology, Seattle Children's Hospital, WA 98105, USA. jonathan.swanson@seattlechildrens.org
authors.forename: Jonathan O
authors.initials: JO
authors.lastname: Swanson
authors.forename: Mahesh M
authors.initials: MM
authors.lastname: Thapa
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Iyer
authors.forename: Randolph K
authors.initials: RK
authors.lastname: Otto
authors.forename: Edward
authors.initials: E
authors.lastname: Weinberger
mesh_terms: D000704:Analysis of Variance; D002983:Clinical Competence; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D018024:Peer Review, Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care; D011872:Radiology Department, Hospital / Q000592:standards*; D012984:Software