Communication is Key: A Radiology Program That Helps Prevent Delayed Diagnoses


For this post, the Department of Quality and Safety asked two members of the Department of Radiology, Taj Qureshi, MPH, CPHRM, program manager of Quality, Safety and Experience, and Neena Kapoor, MD, director of Diversity, Equity and Inclusion and Quality and Patient Safety officer, to report on one of the major patient safety initiatives underway in Radiology.

According to the American College of Radiology, “Radiologists are medical doctors that specialize in diagnosing and treating injuries and diseases using medical imaging.1” Medical imaging are tests that scan the body to help detect certain diseases or conditions. For example, an X-ray is a test that helps radiologists diagnose patients with broken bones.

Many times, a radiologist will review a patient’s test results and recommend follow-up tests be performed within a certain amount of time. It is important that the need for this follow-up is clearly communicated to patients and the patient’s care team so that tests are completed within the appropriate timeframe.

For example, a radiologist may identify a mass on an image of a patient’s lung that they believe is cancer. However, before diagnosing the patient, a radiologist may recommend the patient have a follow-up test performed in three months to review any changes or improvements to the patient’s images. If the recommended follow-up test is not performed, the cancer diagnosis may be missed, and the patient may not receive the treatment they need in a timely manner.

At the Brigham, whenever there is an opportunity to improve a process to ensure patient safety, we do everything possible to directly address the issue.

In October 2019, the Department of Radiology at Brigham Health launched a program called “Addressing Radiology Recommendations Collaboratively,” or (ARRC), to help reduce missed and delayed diagnoses in both the outpatient and inpatient hospital care settings.

ARRC helps ensure radiology tests with any findings that require follow-up or additional imaging have a collaborative care plan communicated and completed between the radiologist and the patient’s care team. The program includes several follow-up options to ensure no patient “falls through cracks.” Using these follow up methods, ARRC ensures all recommended follow-up tests are ordered, scheduled, and tracked to completion.

ARRC is on pace to track approximately 10,000 follow-up test recommendations across 10 radiology divisions per year at the Brigham, with initial data showing that 87 percent of tests reviewed as part of this program have been performed on time. For patients who are not imaged on time, a Safety Net Team sends letters to patients and their providers to notify them of imaging findings and the need for subsequent imaging.

Through innovation and collaboration, we believe ARRC will help us continue to improve the quality of radiology reports and patient safety at the Brigham.


  1. American College of Radiology. What is a Radiologist?