title: Double reading rates and quality assurance practices in Norwegian hospital radiology departments: two parallel national surveys.
abstract: BACKGROUND
  Double reading as a quality assurance (QA) tool is employed extensively in Norwegian hospital radiology departments. The practice is resource consuming and regularly debated.
  
  
  OBJECTIVE
  To investigate the rates of double reading in Norwegian hospital radiology departments, to identify department characteristics associated with double reading rates, and to investigate associations between double reading and other quality improvement.
  
  
  METHODS
  We issued two parallel national surveys to management and to consultant radiologists, respectively. Management was defined as the chief medical officer and/or the head of the radiology department. The management survey covered staffing, perceived resource situation, double reading, guidelines, and quality improvement. The radiologist survey served to validate management responses concerning double reading. Management survey items concerning practices of quality improvement were organized into three indices reflecting different quality approaches, namely: appropriateness of investigations; personal performance feedback; and system performance feedback.
  
  
  RESULTS
  The response rates of the surveys were 100% (45/45) for management and 55% (266/483) for radiologists. Of all exams read by consultants, 33% were double read. The double reading rate was highest in university hospital departments (59%), intermediate in other teaching departments (30%), and lowest in non-teaching departments (11%) (P = 0.01). Among the quality indices, mean scores were highest on appropriateness index (68%), intermediate on the person index (56%), and lowest on system index (37%). There were no correlations between double reading rates and scores on any of the quality indices.
  
  
  CONCLUSIONS
  The rate of double reading in Norwegian hospital radiology is significantly correlated to department teaching status, but not to other practices of quality work.
authors.affiliation: Department of Diagnostic Imaging, Akershus University Hospital, Norway peter.m.lauritzen@gmail.com.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Lauritzen
authors.affiliation: Department of Diagnostic Imaging, Akershus University Hospital, Norway Institute of Clinical Medicine, University of Oslo, Norway.
authors.forename: Petter
authors.initials: P
authors.lastname: Hurlen
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway Department of Radiology and Nuclear Imaging, Oslo University Hospital, Norway.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Sandbæk
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway Health Services Research Unit, Akershus University Hospital, Norway.
authors.forename: Pål
authors.initials: P
authors.lastname: Gulbrandsen
mesh_terms: D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D009664:Norway; D015588:Observer Variation; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D011872:Radiology Department, Hospital / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019564:Unnecessary Procedures
keywords: QA/QC; health policy and practice and observer performance; safety