The Quality Use of Diagnostic Imaging (QUDI) Program

What is QUDI?

The Quality Use of Diagnostic Imaging (QUDI) Program is a radiology quality and safety program. It aims to support improvements in quality, safety and sustainability of radiology services in Australia. It is committed to the main principles of quality health service delivery:

  • Safety
  • Effectiveness
  • Appropriateness
  • Acceptability
  • Access
  • Efficiency

The Quality Use of Diagnostic Imaging (QUDI) Program is unique: there is nothing like it in Australia or internationally. It addresses the issues particular to quality service provision in diagnostic imaging. There is no other quality or safety program in Australia that has the people, the structure, or the professional and industry experience and support to do this effectively. The QUDI Program is an essential part of national initiatives to promote quality in the healthcare sector. This program places the consumer at the centre of the process.

In the financial year 2007-08, over 16 million DI examinations were performed, at a cost of over $1.6 billion to Australian taxpayers. Without the QUDI Program, there is no mechanism for measuring, understanding or influencing the quality of these diagnostic imaging services.

About QUDI

The initial phase of the QUDI Program was established under the Radiology Quality and Outlays Memorandum of Understanding and managed by RANZCR through a funding grant of $1M per annum over five years from 2004 - 2008. The Program developed a framework for a systems and evidence-based approach to the appropriate and quality use of diagnostic imaging services in Australia.

Amongst the many project findings completed during this time period, the following critical questions have been identified and/or re-affirmed:

  • Is this imaging actually necessary or appropriate?
  • Are consumers of healthcare and clinicians who refer patients for imaging well informed about the risks and benefits so that they are able to make clinically appropriate, informed choices?
  • Is the imaging that is performed being performed safely & does it meet best practice standards?
  • Is access to imaging services adequate and equitable?
  • Where are errors made in the diagnostic process, how common are they, who makes them, and how might they be prevented?
  • How are the results of imaging tests communicated to referring clinicians, and does this meet their needs and those of consumers?

The QUDI projects archive presents the outcomes of QUDI projects from 2005-08. Final reports for each project are published and, where necessary, the Royal Australian and New Zealand College of Radiologists (the RANZCR) has prepared project summaries and responses to the project findings. These documents are used to inform the RANZCR Council and the radiology profession about critical issues raised by the projects, especially when findings influence the radiology training curriculum and the RANZCR Standards of Practice. Other supporting documents are posted where appropriate.

What was QUDI's focus for 2008-2009?

With a budget of just over $900,000, QUDI undertook projects that address key aspects of good practice in radiology. The projects included:

  1. Developing consumer and referrer information material about radiology and associated website
  2. Optimising the radiation dose delivered during CT examinations using a quality improvement activity (QIA).
  3. Evaluating the evidence based medicine and critical appraisal of literature on-line training program. A web-based resource for publishing appraisals has also been developed
  4. Developing guiding principles for best practice in radiology reports to improve information flow between radiologists and referrers.
  5. Continuing the Radiology Events Register: A database that collates and supports analysis of adverse events and near misses in radiology. The ultimate aim is to provide evidence to support quality improvements in radiology practice.

See QUDI 2010 & 2011 for information about current QUDI projects.

Why is QUDI important?

Quality improvement is a part of modern medicine and good practice. In many areas these changes are being driven by others and imposed upon clinical staff. Radiologists are privileged to have a program like QUDI driving change in diagnostic imaging. We are able to ensure that quality issues in radiology are addressed in a way that is appropriate to real life radiology. Through QUDI, radiologists have the opportunity to have real involvement in the development of quality in radiology into the future.

Who is involved in QUDI?

QUDI has two staff members who work at the RANZCR offices in Sydney.

A/Prof Stacy Goergen, MBBS, FRANZCR, M.Clin.Epi., is the Clinical Advisor for a number of QUDI Projects for 2010 & 2011. She provides significant clinical leadership in this role.

There are a large number of radiologists who generously give their time on many of the QUDI projects – in particular there are now over 60 radiologists from around Australia involved in the consumer information project.

Governance

Quality in radiology relies not only on radiologists, but on a variety of groups that have a direct impact on, or are affected by, radiology services, including Australian consumers. The QUDI Program actively engages a range of health care providers, allied health and consumers in the current project management reference groups. This represents the broad range of stakeholder interests in Australian radiology.

Justification of claims

The QUDI team believes in the quality of the information on InsideRadiology, and in the methodology used to develop it. The justification of claims explains why.

How is QUDI funded?

Projects managed by the QUDI Program are funded by the Australian Government Department of Health and Ageing under the diagnostic imaging quality projects program. The QUDI Program is managed by the Royal Australian and New Zealand College of Radiologists (RANZCR).