title: Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.
abstract: OBJECTIVE
  To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology.
  
  
  METHODS
  We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda.
  
  
  RESULTS
  There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist).
  
  
  CONCLUSIONS
  Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested.
authors: Department of Radiology, Beth Israel Medical Center, First Ave at 16th St, 2K-01, New York City, NY 10003. Electronic address: dpowell@chpnet.org.
authors: Daniel K
authors: DK
authors: Powell
authors: Department of Radiology, St. Luke's Roosevelt Hospital, New York City, NY.
authors: Eaton
authors: E
authors: Lin
authors: Department of Radiology, Beth Israel Medical Center, First Ave at 16th St, 2K-01, New York City, NY 10003.
authors: James E
authors: JE
authors: Silberzweig
authors: Department of Radiology, St. Luke's Roosevelt Hospital, New York City, NY.
authors: Nolan J
authors: NJ
authors: Kagetsu
mesh_terms: D057189:Checklist / Q000592:standards* / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D004282:Documentation / Q000592:standards* / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000706:statistics & numerical data; D008446:Maxillofacial Injuries / Q000000981:diagnostic imaging*; D009518:New York; D015588:Observer Variation; D011859:Radiography; D011871:Radiology / Q000592:standards* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Structured reporting; checklists; quality improvement; radiology reporting; resident accuracy; resident education; safety