Dr Howard Galloway
Orthopaedic and Sports
The Quality Use of Diagnostic Imaging (QUDI) programme is an initiative administered by the Royal Australia and New Zealand College of Radiologists (RANZCR) on behalf of the profession and funded by the Australian government to systematically collect and disseminate evidence to inform quality improvement in radiology. It is one of a three-part quality strategy including the RANZCR practice accreditation programme and the International Radiology Quality Network (IRQN).
Australia’s health system is largely funded by the national government through the medicare universal health insurance scheme. Expenditure on radiology is governed by a capped Memorandum of Understanding (MOU) between the RANZCR, the Australian Diagnostic Imaging Association (ADIA) representing the owners of radiology practices (many of whom in Australia are now corporate entities) and the government. The programme was initially funded for five years at 0.1% of the total radiology budget (AUS$3 million). A national strategy for the programme was developed by the RANZCR in consultation with the government. From the national strategy, annual work plans and specific projects are developed.
Quality Sub Programmes
The following are sub-programmes, each with different objectives:
• Quality Consumer Services (CS): Develops consumer- focused, accessible and coordinated services.
• Quality Referrals/Ordering (QR): Supports evidence- based referrals that facilitate the most appropriate diagnostic imaging service provision.
• Quality Assured Services/Accredited Providers (QS): Ensures professional practice standards and supervision requirements, through uniform standards, practice guidelines and accreditation.
• Economically Sustainable Services (ES): Provides cost benefit studies and develops cost-effective practices, services and referral and review platforms.
• Quality Into Action (QIA): Facilitates implementation of the findings of QUDI projects into practice and policy, including the annual research seminar, key stakeholder briefings and project development workshops.
• Evaluation Programme: Reviews the appropriateness of systems, processes and documentation in place for the administration of the grants, to determine whether programme resources are applied effectively.
Who is Responsible for Carrying out Objectives?
The Radiology Management
Committee (RMC), which manages the radiology MOU and includes representatives from the college, the ADIA and the government is responsible for determining the extent and nature of the programme.
RANZCR is responsible for:
• Developing and implementing the programme framework, outline work plan and annual work plans;
• Commissioning, supporting and monitoring of projects within the annual work plans;
• Evaluating and reporting on the outcomes of the programme; and,
• Administering and acquitting programme funding.
The QUDI Advisory Group includes representatives of public and private sector providers, academic radiologists, primary care and specialist referrers and consumers. It is responsible for:
• Providing advice on, and assistance with, the development of the programme;
• The outline work plan, annual work plans and all projects and budgets over the life of the QUDI Agreement; and,
• Advising RANZCR on programme evaluation and making a final report to the government.
The QUDI Technical Reference Group includes radiologists with specific expertise in one or more areas of radiology and is responsible for:
• Providing the programme manager with technical advice, and,
• Assisting in the design, development and implementation of sub-programmes and projects within the programme outline work plan and annual work plans.
The QUDI Liaison Radiologist position was created to:
• Establish and manage a national out reach strategy to inform radiologists on the activities of the QUDI programme.
• Lead the QUDI Advisory Committee, manage the QUDI Technical Reference Group and assist in revision of project briefs and the design of new projects.
Input into project development is actively sought from members of RANZCR and other interested parties through a number of mechanisms. The concepts are subject to a thorough workup through to release of a project brief. Proposals are received from interested investigators (who may be commercial consultancies, academic organisations or research groups or individuals).
After thorough standardised evaluation, the projects are commissioned and funded. There is ongoing monitoring of the projects through quarterly reports.
The results of projects are reviewed by college fellows led by the TRG and then:
• Published on the RANZCR website (www.ranzcr.edu.au).
• Summarised in the QUDI e-newsletter.
• Presented at the annual QUDI research seminar.
• Presented at national and international meetings.
• Published in the literature.
The strength of the programme is its ability to provide a structured and fully-funded means of systematically addressing quality issues in radiology. It impacts the practice of radiology by:
• Informing standards of practice;
• Providing evidence for RANZCR policy development;
• Informing and influencing government policy;
• Informing practicing radiologists and referring medical practitioners; and,
• Informing consumers and patients about the role, practice and outcomes of quality radiology practice.
Further details of the programme can be found by contacting Programme Director
Ms Jane Grimm email@example.com or visiting the RANZCR website