Communication and empathy skills: Essential requisites for patient-centered radiology care

Which aspects of patient experience are the 'moment of truth' in the healthcare context: a multicentre cross-sectional study in China

OBJECTIVE

This study aimed to examine the differential magnitude of associations between specific dimensions of patient experience and overall patient satisfaction.

DESIGN

A descriptive, cross-sectional design was used to collect patient experience and overall satisfaction data.

SETTING

Participants were recruited at one tertiary general hospital, one tertiary specialised hospital, and one secondary hospital in Shanghai, China. These three institutes represent the main kinds of hospitals in the Chinese healthcare system.

PARTICIPANTS

1532 inpatients were recruited, and 1469 were included. The inclusion criteria were as follows: (1) having received inpatient service for at least 2 days; (2) able to understand the questions in the questionnaires; and (3) aged>18 years old. Patients who had impaired cognitive function and completed the questionnaires with missing information were excluded.

PRIMARY AND SECONDARY OUTCOME MEASURE

Patient experience was measured using the Inpatient Experience with Nursing Care Scale, which is widely used in the China. The overall patient satisfaction was measured with 10-point response option.

RESULTS

The LASSO (least absolute shrinkage and selection operator) regression results showed that as the penalty factor (λ) = 0.0162, age, marriage status, financial status, length of hospital stay and numbers of previous of hospitalisation and six dimensions of nursing care remained in the model. As λ increases to 0.1862, only four patient experience variables, potentially the most influential on patient satisfaction, remained in the model. Patient experience with emotional support was the most significant dimension explaining patient satisfaction (β=0.1564), the second most significant dimension was admission and discharge management (β=0.1562), and the third was monitoring and coping with the progress of diseases (β=0.0613).

CONCLUSION

Patient experience with emotional support, admission and discharge management, monitoring and coping with the progress of diseases, and information and education are the most significant dimensions explaining patient satisfaction.

[Patient-centered radiology : What patients want from radiologists]

BACKGROUND

In the transition from volume-based to value-based radiology, patient communication plays a crucial role in terms of patient-centeredness in radiology. This overview article aims to describe various patient contact situations in a radiology setting and discuss them based on current literature, including any recommendations for action if applicable.

OBJECTIVES

What do patients wish for from radiologists?

MATERIALS AND METHODS

Digital literature research with a narrative summary of important publications on patient-centeredness in the context of communication in the radiology-patient relationship.

RESULTS

There is limited literature available in most areas regarding communication between radiology and patients. The most common type of literature found is surveys that assess patients' opinions, which sometimes yield divergent results regarding preferences for direct communication with radiologists after the examination. However, it has been shown that direct patient conversations and an empathetic physician-patient relationship allow for a positive evaluation of radiology and foster a sense of appreciation.

CONCLUSION

As we transition from volume-based to value-based radiology, it will be crucial for radiology to optimize the physician-patient relationship through improved communication, both verbally and by utilizing new media.

[Patient-centered vs. employee-centered radiology : Does this pose a conflict?]

BACKGROUND

Patient-centered radiology and employee-centered radiology are being increasingly discussed as an extension of the established structure- and process-oriented management perspective. Concerning potential conflicts, it is unclear if and how these approaches should best be implemented in a radiology department.

OBJECTIVE

The aim of this narrative review is to identify and critically correlate underlying characteristics of patient-centered and employee-centered approaches including their similarities, conflicts, and synergies as applicable to the radiological work environment.

MATERIALS AND METHODS

Based on a literature search using PubMed, Scopus, Web of Science, and Google Scholar, the current body of knowledge regarding patient- and employee-centered radiology is presented.

RESULTS

Patient- and employee-centered radiology focus on the individual needs of patients and employees, respectively, and promise to improve patient satisfaction, healthcare outcomes, and organizational performance. Conflicts result from an increased organizational complexity and the concurrent utilization of limited resources, such as time, money, and staff. Overall, however, synergies outweigh the potential conflicts.

CONCLUSIONS

Successful implementation of patient- and employee-centered approaches in radiology requires a human-centered leadership approach and an overarching strategy with the execution of specific interventions in the processes. We provide specific recommendations to this effect.

Patient communication in radiology: Moving up the agenda

Optimised communication between patients and the imaging team is an essential component of providing patient-centred and value-based care. Communication with patients can be challenging in the setting of busy radiology departments where there is a focus on efficient and accurate diagnosis. Traditionally, most results are provided directly to the referring clinician. However, the importance of direct communication between the radiologist and patient is increasingly relevant, particularly in the context of face-to-face settings such as rapid assessment and ultrasound clinics, and interventional radiology, as well as in written form through electronic patient portals. Artificial intelligence tools may improve efficiency, allowing more time for radiologists to communicate directly with patients. There is a need for dedicated training in communication skills for imaging professionals. This review considers the topic of patient communication in the setting of imaging departments and discusses the ways that communication skills may be improved through training and through harnessing emerging digital technologies that may enhance the quality of communication.

Patient Centered Radiology - An Introduction in Form of a Narrative Review

BACKGROUND

Patient centered radiology represents a crucial aspect for modern sustainable radiology. The definition of patient-centered consists of a focus on patients' individual values and wishes with a respectful integration in medical decisions. In this narrative review we try to give a practical introduction into this complex topic with the extension to a person-centered radiology, which additionally encompasses values and wishes of radiological and other medical colleagues.

METHODS

Medline search between 2010 and 2021 using "patient-centered radiology" with additional subjective selection of articles for this narrative review.

RESULTS

Regarding patients' experiences the main literature focus were patients' fears of examinations (movement restrictions, uncertainty). Most patients would prefer a direct communication with the radiologist after the examination. Regarding interdisciplinary communication the radiological expertise and quality is highly appreciated; however, there was a general wish for more structured- or itemized reporting. Concerning working conditions radiologists were satisfied despite high psychosocial working pressure.

CONCLUSION

Most of the literature on this topic consists of surveys evaluating the current state. Studies on interventions such as improved information before examinations or patient-readable reports are still scarce. There is a dilemma between an increasing radiological workload and the simultaneous wish for more patient-centered approaches such as direct radiologist-patient communications in the daily routine. Still on our way to a more value-based radiology we have to focus on patient communications and a patient-centered medicine.

KEY POINTS

· Patient centered radiology has a focus on the integration of patients' individual values and wishes in their decisions.. · Radiologists are clinicians, who an additional diagnostic and therapeutic surplus for patients and referring physicians.. · The recent literature on this topic consists basically on the evaluation of the current status.. · Most patients prefer a direct communication with the radiologist.. · To gain a "value based" radiology we to focus on an optimized communication with patients and referring physicians..

CITATION FORMAT

· Schreyer AG, Schneider K, Dendl LM et al. Patient Centered Radiology - An Introduction in Form of a Narrative Review. Fortschr Röntgenstr 2022; 194: 873 - 881.

What radiologists need to know about patients' expectations: P.A.T.I.E.N.T.S C.A.R.E.R.S A.I.M.S

The Patient Advisory Group (PAG) of the European Society of Radiology aims to highlight, in this short paper, patients’ expectations from the radiological community and support workers, throughout the patient’s medical imaging journey for completion of diagnostic or interventional examinations. In order to maintain constant awareness of patients’ expectations, key expectations have been summarised in an easy-to-remember mnemonic: PATIENTS CARERS AIMS.

Due to disparate healthcare systems and medical imaging services in Europe, not all patient expectations can be systematically met, but healthcare providers should be mindful, when setting up new operational procedures, of the need to focus on patient-centred needs and care. At times when new or improved technology is being introduced, such as artificial intelligence applications, telemedicine, robotisation of interventional procedures and digitised records, the impact on radiologist–patient communication and interactions should be considered.

The concept of the invisible radiologist in the era of artificial intelligence

The radiologists were traditionally working in the background. What upgraded them as physicians during the second half of the past century was their clinical training and function precipitated by the evolution of Interventional Radiology and Medical Imaging, especially with ultrasonography. These allowed them to participate in patient's diagnosis and treatment by direct contact as well asvia multidisciplinary medical consultations. The wide application of teleradiology and PACS pushed radiologists back again which is no longer acceptable, especially in view of the amazing applications of artificial intelligence (AI) in Radiology. It is our belief that clinical radiologists have to be able to control the penetration of AI in Radiology, securing their work for the benefit of both clinicians and patients.

Value-based radiology: what is the ESR doing, and what should we do in the future?

Value-based radiology (VBR) is rapidly gaining ground as a means of considering the input of radiology practice into individual and societal healthcare, and represents a welcome move away from older metrics focused on counting studies performed, without consideration of whether these studies contributed positively to patient management or to society as a whole. Intrinsic to the process of considering whether radiology activity confers value is recognising the breadth of involvement of radiology in healthcare delivery; previous ESR and multi-society publications have explored this, and have sought to highlight the many ways in which our specialty contributes to patient welfare. This paper is intended to highlight some current ESR activities which already contribute substantially to value creation and delivery, and to outline a selection of practical steps which could be taken by the ESR in the future to enhance value.

Patient summary

Value-based radiology (VBR) is a conceptual means of looking at the benefits conferred on patients and on society as a whole by provision of radiology services, as opposed to older means of counting numbers of radiology studies performed, without consideration of whether or not those studies contributed overall value. VBR will become increasingly important in the future as a means of determining resources. The ESR has been a leader in advancing VBR concepts and educating radiologists about this novel way of looking at what we do. This paper is designed to highlight current ESR activities which contribute value to healthcare, and to consider other ways in which the ESR could potentially support value enhancement in the future.