Standardizing architecture and governance of radiology clinical checklist development.

193 Background: To improve quality of radiology reporting, Cancer Care Ontario’s (CCO) Cancer Imaging Program established synoptic radiology reporting as a priority area. Program goals are to implement standardized radiology reports across the province, improving communication between referring and interpreting physicians and providing a standardized foundation for staging data collection and population health research. Although there are libraries of structured radiology clinical checklists, development methodologies quality vary. To support ongoing development and provide a framework to assess existing checklists, the program developed and published two white papers. Methods: To ensure checklists are consistent in format, the first white paper provides guidance on ‘architecture’ (high-level elements) of a cancer imaging report. To ensure the content of adopted checklists are based on high-quality evidence, the second white paper focuses on clinical checklist development governance. Both white papers were developed in consultation with multidisciplinary expert panels assembled by CCO and underwent peer review prior to being made available. Results: The architecture white paper outlines the minimum mandatory elements for cancer imaging reports. The elements to be included in these reports are: demographics, relevant clinical information, body of the report, and impression. This paper provides specific guidance for expert panels in the development of new clinical checklists as well as criteria for reviewing existing checklists. The governance white paper provides a clear methodology for a systematic approach to clinical checklist development for synoptic radiology. Included are recommendations on the constitution of the clinical expert panels, the level of evidence needed to support checklist items, external review of the checklist, and periodic checklist maintenance. Conclusions: CCO has developed two white papers that serve as a guide for both CCO and external parties in the creation of high-quality clinical checklists. Improved standardization of the structure and development approach for clinical checklists facilitates both in-house development and adoption of third party checklists.