According to AHRQ’s definition of a high-reliability organization (HRO), this requires robust process improvement, a culture of safety, and continuous learning. By adopting these principles in radiology, health systems strive to close the loop on follow-up recommendations for both incidental and critical findings. Standardizing report templates, automating tracking systems, and implementing shared accountability among radiologists, referring clinicians, and patients foster transparency and timeliness.

Several studies underscore how missed follow-ups increase the risk of missed or late diagnoses. A consistent focus on communication and follow-up processes—anchored in the HRO framework—can help mitigate liability risk and optimize patient outcomes.

High-reliability radiology follow-up also involves real-time analytics and measurable metrics. Emerging measures, such as the American College of Radiology’s Closing the Loop initiatives, offer a structured method for monitoring compliance and improving patient engagement. By measuring the rate of completed recommended imaging and identifying barriers like provider disagreement or patient noncompliance, organizations can tailor interventions that enhance adherence and reduce system gaps. Ultimately, high reliability radiology follow-up fosters a safety culture, supporting accurate diagnosis, timely treatment, and strengthened relationships among patients, clinicians, and health systems. This integrated approach not only reduces adverse events but also bolsters confidence in the quality of care across the radiology landscape.