Everybody

It is of the utmost importance that each individual ensures optimal functionality of their immediate work environment at all times. This encompasses a comprehensive examination of the workstation in use, ensuring that it is free from any technical issues, situated in an appropriate location, and equipped with the latest software and updated operating system. Additionally, it is essential to verify the availability of essential connections, such as archives and patient information systems. Other responsibilities include organizing a stress-free commute, having an escalation path in the event of sick children, and taking into account the stress factors already mentioned. It is, of course, essential to participate in the requisite of continuous medical education (CME) courses.

Senior radiologist/consultant

It is incumbent upon the senior radiologist/consultant to ensure that examinations are conducted with the requisite quality and within the appropriate dose range. It is also incumbent upon the senior radiologist/consultant to report to the unit head any instances of frequent incorrect referrals, which may result in unnecessary exposure to radiation doses. A prompt review of the resident’s report is beneficial for all parties involved, as it helps to circumvent potential stressors.

The department head/chair

It is the responsibility of the individual in this role to oversee all aspects of their respective unit. A significant objective is to enhance the team’s resilience. Resilience can be defined as the “ability to bounce back from adversity” [26].

In the field of medicine, it can be defined as the “capacity of individuals and groups to respond effectively to adversity” [27]. In the context of radiology, this can be understood as the capacity to adapt and overcome the challenges associated with patient care, technological advancements, increasing workloads, and evolving healthcare policies.

It is imperative that resilience is cultivated in order to maintain the highest standards of patient care, to mitigate the risk of burnout among team members, and to guarantee the long-term sustainability of radiology services.

Ensuring resilience is a multifaceted endeavor, with the establishment of a transparent organizational structure and the delineation of clear responsibilities representing two of the most crucial elements. A balanced workload is an effective method of preventing dissatisfaction within the team. Furthermore, active collaboration with related professional groups, such as radiographers and medical physicists, is a crucial aspect to consider. The current trend towards more part-time work provides the opportunity to better adapt schedules to individual needs of chronobiology.

Establishing a secure setting for the management of diagnostic errors, unidentified findings, and misinterpretation represents a further fundamental aspect of effective team leadership.

Informational technology (IT) managers

IT managers need to ensure that the reporting devices and IT infrastructure comply with the relevant national and/or international legal requirements and function properly, including security updates.

Error prevention and handling

In light of potential diagnostic errors, missed findings, or misinterpretations to occur, it is important that appropriate strategies are put in place, taking into account whether the issues arise within a department or unit, or between either.

Strategies within a department

The implementation of strategies within a department represents a multistage process. A review of residents’ reports is a mandatory requirement in many countries and is also a legal necessity. A culture of discussion and collaboration between colleagues and consultants should be fostered in order to address ambiguous findings. To avoid disrupting the workflow of others, it is recommended that two time slots per day be allocated for the discussion of controversial, non-urgent cases. The presence of radiologists on intensive care units facilitates the acquisition of more detailed clinical information, fosters a greater mutual understanding between clinicians and radiologists, and ultimately leads to more targeted imaging and the avoidance of unnecessary procedures in these vulnerable patients. Radiologists’ imaging visits have proven to be a valuable tool at the author’s institution.

A comprehensive library, radiologic textbooks, atlases, or digital versions are indispensable resources for quality management and education as are teaching files. Finally, “radiology discrepancy/errors” meetings are useful tools and have been further professionalized by the “Radiology Events and Learning Meeting” (REALM) approach [28]. In the Netherlands, for instance, these meetings are mandatory and subject to periodic review at 5-year intervals.

Strategies within the hospital

Interdisciplinary case discussions within hospital settings, involving all relevant clinical specialties, are a valuable tool for the acquisition of knowledge and the fostering of professional development. Furthermore, the implementation of an anonymous “Critical Incident Reporting System (CIRS)” has been demonstrated to be an effective strategy. The results from CIRS implementation in 22 regional, Austrian hospitals and a tertiary hospital have been reported by Sendlhofer et al. [29]. It is important to note that the majority of reported cases were associated with non-compliance with established guidelines.

In the event that a report is to be amended as a result of a second opinion or the introduction of new information (for example, a pathological report), it is imperative to retain the original report. A new report has to be created, incorporating the original one. At the end, a comment is made stating the rationale for the adaptions necessary. This is signed with the author’s name and date and followed by the new interpretation. Typically, hospital information systems incorporate a version control system for reports, with the most recent version always displayed on top. This allows the reader to trace the evolution of the report and understand the rationale behind the discrepancies between versions.

The hospital’s legal department should be involved in cases where a report has resulted in a treatment error of a patient or when forensic or legal implications are likely. In addition to any necessary action, the communication with the patient or provider should be discussed. Anecdotally, we find an offensive strategy in communicating with patients is a superior approach in contrast to remaining silent or attempting to downplay the problem.

Potential role of artificial intelligence

The subject of new AI applications is currently the subject of intense discussion on a daily basis. AI has a long history [21], with the implementation of deep learning representing a significant development. In a statement made in 2016, Geoffrey Hinton, a prominent figure in the field of computer science and a key contributor to the development of deep learning technology, asserted that “It’s just completely obvious that within 5 years, deep learning is going to do better than radiologists” [30]. However, the current situation does not follow this prediction. An overview of the potential role of AI is provided by Gore et al., Choy et al., and Sorantin et al. [21, 31, 32].

“Large Language Models (LLM)” are AI applications that have been deployed as chat-bots on numerous commercial websites. The application of LLM to radiology has yielded varying degrees of success as shown in literature [33, 34].

What is more, the interactions between AI systems and radiologists are diverse, and the improvement in diagnostic performance is not always evident [35]. Thus, for the time being, it is difficult to predict whether these systems will prove effective in reducing errors and misinterpretations. Nevertheless, it is this author’s most profound conviction that AI applications such as image segmentation or a “personal digital assistant” will prove valuable to radiologists [21].