title: Assessing the performance of medical personnel involved in the diagnostic imaging processes in mulago hospital, kampala, Uganda.
abstract: OBJECTIVE
  Uganda, has limited health resources and improving performance of personnel involved in imaging is necessary for efficiency. The objectives of the study were to develop and pilot imaging user performance indices, document non-tangible aspects of performance, and propose ways of improving performance.
  
  
  METHODS
  This was a cross-sectional survey employing triangulation methodology, conducted in Mulago National Referral Hospital over a period of 3 years from 2005 to 2008. The qualitative study used in-depth interviews, focus group discussions, and self-administered questionnaires, to explore clinicians' and radiologists' performancerelated views.
  
  
  RESULTS
  THE STUDY CAME UP WITH FOLLOWING INDICES: appropriate service utilization (ASU), appropriateness of clinician's nonimaging decisions (ANID), and clinical utilization of imaging results (CUI). The ASU, ANID, and CUI were: 94%, 80%, and 97%, respectively. The clinician's requisitioning validity was high (positive likelihood ratio of 10.6) contrasting with a poor validity for detecting those patients not needing imaging (negative likelihood ratio of 0.16). Some requisitions were inappropriate and some requisition and reports lacked detail, clarity, and precision.
  
  
  CONCLUSIONS
  Clinicians perform well at imaging requisition-decisions but there are issues in imaging requisitioning and reporting that need to be addressed to improve performance.
authors.affiliation: Ernest Cook Ultrasound Research and Education Institute (ECUREI), Kampala, Uganda.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kawooya
authors.forename: George
authors.initials: G
authors.lastname: Pariyo
authors.forename: Elsie Kiguli
authors.initials: EK
authors.lastname: Malwadde
authors.forename: Rosemary
authors.initials: R
authors.lastname: Byanyima
authors.forename: Harrient
authors.initials: H
authors.lastname: Kisembo