American Board of Radiology Maintenance of Certification - Part IV: practice quality improvement for radiation oncology.

Maintenance of Certification is a physician-based response to public concerns about the quality of medical care and physician competency in a rapidly evolving, technically demanding specialty. The American Board of Radiology (ABR) has previously described the first three components of the Maintenance of Certification. The ABR is currently developing a program in practice performance, completing Part IV of the competencies. The Practice Quality Improvement (PQI) program is meant to critically evaluate meaningful aspects of a physician's practice in a simple manner, using identifiable metrics and self-assessment to include an action plan for quality improvement. Each diplomate will be expected to complete three PQI projects during a full 10-year Maintenance of Certification cycle. Current diplomates with time-limited certificates will find prorated requirements determined by their year of certification on the ABR Website. Diplomates will have the option of completing zero to two Type I PQI projects (assessing factors relevant to clinical practice by peer review and self-reporting) and one to three Type II projects (i.e., at least one Type II projects of the three required, assessing parameters of practice by comparison with evidence-based guidelines, consensus statements, or peer comparisons; Type II projects are initiated and managed by professional societies). Several examples of Type I projects that might be offered by societies or directly through the ABR are provided, as well as highlights of the two Type II projects that have sought ABR qualification: the American Society for Therapeutic Radiology and Oncology's Performance Assessment for the Advancement of Radiation Oncology Treatment program and American College of Radiology's RO-PEER program. An additional objective of the PQI is to develop national databases for future reference using aggregate data from the PQI projects.