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AJR Am J Roentgenol. 2019 Nov;213(5):1008-1014. doi: 10.2214/AJR.19.21451. Epub 2019 Aug 15.

Radiology Report Template Optimization at an Academic Medical Center.

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Department of Radiology, Center for Evidence-Based Imaging, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA.
Dana-Farber Cancer Institute, Boston, MA.


OBJECTIVE. Variability in reports of the same imaging study performed at the same institution may be confusing to referrers and patients, hindering results communication. The purpose of this study was to introduce a quality improvement initiative aimed at reducing variation in radiology report templates at a large academic center. MATERIALS AND METHODS. The quality improvement initiative was undertaken at a large multisite, multidivision academic radiology practice performing more than 820,000 radiologic examinations annually. A project charter defined the goals, scope, and personnel of the initiative and an escalation pathway for conflict resolution. Standard requirements for templates were initially developed. From September 2017 to May 2018, an oversight committee (24 organ system and modality-based work groups with representatives from nine subspecialty divisions) reviewed and harmonized all institutional radiology report templates across the enterprise irrespective of the imaging site or division that interpreted the study. The primary outcome measure was percentage reduction in report templates after harmonization. The secondary outcome measure was monthly adherence to harmonized templates for 9 months after implementation assessed by manual review of 40 randomly selected reports per month. The paired t test was used to assess template reduction, and the chi-square trend test was used to study trend in adherence to harmonized templates. RESULTS. Among 19,687 total templates at baseline, 597 harmonized templates remained after harmonization (p < 0.001). There was variation in template reduction by work group (multiple p < 0.05; reduction range, 79.2-99.3%). Radiologist adherence to harmonized templates ranged from 88.0% to 100%, unchanged in the 9 months after implementation (p = 0.23, chi-square trend). CONCLUSION. A radiology report harmonization initiative reduced 97.0% of report templates with a sustained high degree of adherence to harmonized templates after implementation at a large multisite multidivision academic radiology practice.


harmonization; informatics; report templates; variation


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