QuIRI (quality improvement and research in imaging) program: a means to promote and coordinate research and quality-improvement activities in radiology

Quality-improvement practices and research are important in radiology for multiple reasons [1–9]. For all of us involved in medical imaging, regardless of the type of practice, part of our vision and mission is improving the health of all patients through imaging delivery. While certainly this involves direct patient care, improving the practice of medical imaging delivery as well as sharing clinical experiences can expand our vision and our mission beyond the immediate patients we are serving. In addition, patients as well as regulatory bodies are increasingly demanding that physicians practice quality improvement through mechanisms such as the maintenance of certification [10] and the potential maintenance of licensure. It can also be argued that participation in quality-improvement and research activities can increase work satisfaction and engagement of radiologists. Finally, active quality-improvement and research programs are essential for radiology to preserve its leadership role in medical imaging [1–6]. At our institution, we have put in place a Quality Improvement in Research and Imaging (QuIRI) program. The purpose of this manuscript is to describe the QuIRI process and how it has positively affected our research and qualityimprovement program. A productive research program can enhance the prestige and clout of a radiology department within its institution and of the subspecialty of radiology within medicine. Cultivation of quality-improvement and research activities is essential to optimizing radiology’s role in health care reform. Quality will be a differentiating factor in a commodity imaging market [9]. A number of barriers have been identified, making development of research and quality-improvement initiatives difficult in radiology [11–14]. These include the historical lack of research training as a component of radiology training, increased clinical responsibilities related to increasing imaging volumes and decreased reimbursement, the inability to cover total research expenses even in successful grant-funded programs, the NIH salary cap being lower than most radiologists’ salaries, alignment of radiologists’ incentives and culture, and vacant positions within academic radiology departments [11–14]. These problems have prompted a number of articles describing important steps in programmatic aspects necessary to create a successful quality-improvement and research program in a department of radiology [1–15]. In our department, we have put in place a number of ways to stress the importance of research among our clinical radiologists and to promote a culture of research [7] as well as establish processes to promote quality and safety [15–21]. More recently, we have put in place the QuIRI program. L. F. Donnelly Departments of Radiology and Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA