The standardized thyroid ultrasound report in a regional thyroid network in the Netherlands: a mixed-methods implementation analysis.

Introduction Thyroid cancer is the most common endocrine malignancy, and its diagnosis relies on thyroid ultrasound and fine needle aspiration (FNA). To ensure uniform and complete communication between radiologist and clinician, a standardized thyroid ultrasound reporting protocol was implemented in December 2019 across a regional thyroid network in the Netherlands. This study aims to quantitatively assess the adherence to the protocol and qualitatively assess the reflection of the stakeholders on this protocol in its current form. Methods A sample was collected of ultrasound reports (n = 100) from three hospitals three years before and after implementation, and analyzed focusing on the description of key points in the standardized report. Additionally, semi-structured interviews were conducted. The interview structure is based on the grounded-theory approach using the Capability, Opportunity, Motivation - Behavior (COM-B) model for instituting change. Results The quantitative analysis showed that Thyroid Imaging Reporting and Data System (TI-RADS) classification pre-implementation was described in 0.0% of reports, and only in 37.5% of reports post-implementation. Lymph nodes were described pre-implementation in 80.0% of reports and 95.0% of reports post-implementation. Qualitative analysis revealed that the primary issue with using the standardized ultrasound report revolves around time constraints. Collaboration among endocrinologists, surgeons, and radiologists was mentioned to be essential for developing a comprehensive protocol with widespread acceptance. Encouraging the involvement of new radiologists is crucial. To maintain protocol quality and utilization, it is recommended that there is a culture of open communication for feedback within the thyroid network. Conclusion The findings underscore the importance of continuous improvement efforts and clear communication channels to enhance reporting practices and ensure quality assurance for thyroid ultrasounds between, and within health care institutions. Clinical Relevance: Effective implementation of a standardized thyroid ultrasound reporting protocol within a regional network in the Netherlands enhances diagnostic accuracy and treatment planning for thyroid nodules and cancer, optimizing patient care across multiple healthcare institutions and maximizing healthcare resources.