Multidisciplinary quality improvement initiative to standardize reporting of lung cancer screening

Laura Cubillos, Alison T. Brenner, Katherine Birchard, Louise M. Henderson, Paul L. Molina, Michael Pignone, Shana Ratner, M. Patricia Rivera, Laura Jones, Daniel S. Reuland


Structured reporting of lung cancer screening (LCS) results with low-dose computed tomography (LDCT) is necessary for appropriate follow-up and management of lung nodules. We describe processes for standardizing the reporting and tracking of screen-detected lung nodules by increasing documentation of Lung-RADS categorization of lung nodules. Our multidisciplinary team developed a project charter and key driver diagram, revised the radiology reporting template, and provided monthly audit reports to thoracic radiologists. Quarterly from Q1-2015 to Q2-2016, we measured the proportion of screening LDCT reports that included a documented Lung-RADS category. In Q1- and Q2-2015, no LDCT scans contained a Lung-RADS assessment. By the end of Q1-2016, 94% of screening LDCTs contained a Lung-RADS assessment with a recommended follow-up action. We developed systematic processes for lung nodule categorization, documentation, and tracking using Lung-RADS that improved structured reporting at one academic medical center.