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A new complication registration system for errors in radiology: Initial 5-year experience in a tertiary care radiology department

•A new radiologic complication registration system was introduced in this study.•Implementation of this new system in clinical practice proved feasible.•Its yield in a tertiary care radiology department was described. To describe and evaluate our initial 5-year experience with a new complication reg...

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Bibliographic Details
Published in:European journal of radiology 2020-09, Vol.130, p.109167-109167, Article 109167
Main Authors: Carrara, Marco, Yakar, Derya, Kasalak, Ömer, Kwee, Thomas C.
Format: Article
Language:English
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Summary:•A new radiologic complication registration system was introduced in this study.•Implementation of this new system in clinical practice proved feasible.•Its yield in a tertiary care radiology department was described. To describe and evaluate our initial 5-year experience with a new complication registration system for errors in radiology. This study reviewed all cases that were submitted to a new complication registration system of a tertiary care radiology department between 2015–2019. Sixty-seven cases were included. In the group of diagnostic complications/errors (n = 34), there were 21 perceptual errors and 13 cognitive errors. This 61.8 % (21/34) perceptual error rate was not significantly different (P = 0.297) from the 70 % perceptual error rate known from previous literature. In the group of interventional complications (n=19), most cases (47.4 % [9/19]) concerned symptomatic or major hemorrhage. In the group of organizational complications/errors (n=14), the leading incident type according to the International Classification System for Patient Safety was clinical process/procedure with wrong body part/side/site as subclassification (35.7 % [5/14]). Harm severities were none (n=35), mild (n=10), moderate (n=10), severe (n=6), death (n=5), and unknown (n=1). Harm severity of interventional complications was significantly higher (P 
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2020.109167