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Noguchi T, Tanaka K, Okada Y, Fukuizumi K, Yokoda S, Dairiki M, Yamashita K, Shin S, Wada N, Harada S, Morita S. A practical system that enables physicians to respond expeditiously to significant unexpected findings (SUFs) in radiological reports. Jpn J Radiol 2021; 39:424-432. [PMID: 33386574 DOI: 10.1007/s11604-020-01077-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To demonstrate effectiveness of our present radiological report check flowchart enabling physicians to respond to significant unexpected findings (SUFs), by comparing the response periods from the examination date to the action date on untreated SUFs between the previous and present versions of our flowchart. METHODS In the flowchart's previous version used February-October 2019, SUFs, which were notified by email, were audited every month. The physician received a phone call and was asked to act on the untreated SUF. In the flowchart's present version used from November 2019 to May 2020, SUFs were audited every 2 weeks. The physician and his/her chief were asked to return a written response to the untreated SUF. We evaluated the difference in the response periods between the previous and present versions of the flowchart. RESULTS With the previous flowchart's use, untreated SUFs were 43 of 229 SUFs (18.8%) with the present flowchart untreated SUFs were 22 of 130 SUFs (16.9%). All SUFs in both periods were eventually responded. The present flowchart (median/range, 25/11-70 days) significantly had shorter response periods than the previous flowchart (70/16-290 days) (p < 0.0001). CONCLUSION The present flowchart employing a shortened primary audit interval, a written response, and the department chief's intervention, helped reduce the response periods.
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Affiliation(s)
- Tomoyuki Noguchi
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan. .,Department of Clinical Research, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan. .,Education and Training Office, Department of Clinical Research, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan.
| | - Kumi Tanaka
- Medical Safety Management Unit, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan.,Department of Nursing, National Hospital Organization Kokura Medical Center, 10-10 Harugaoka, Kokuraminami-ku, Kitakyushu City, Fukuoka Province, Japan
| | - Yasushi Okada
- Medical Safety Management Unit, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Kunitaka Fukuizumi
- Medical Information Management Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Sachiyo Yokoda
- Medical Safety Management Unit, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan.,Department of Nursing, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Motoko Dairiki
- Medical Safety Management Unit, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan.,Department of Nursing, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Koji Yamashita
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Seitaro Shin
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Noriaki Wada
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Shino Harada
- Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
| | - Shigeki Morita
- The Director of the hospital, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, Japan
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Thai JN, Josemon R, Smith S, Morey J, Sison CP, Landau E, Chaya N, Peti S, Jbara ME, Sarkany D, Raden M, Brenner AI. Adding value to imaging services: a survey of patient and referring physician preferences for direct radiologic reporting of results. Clin Imaging 2020; 73:73-78. [PMID: 33316709 DOI: 10.1016/j.clinimag.2020.11.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/06/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify preferences of patients and referring physicians for direct patient communication and notification of radiologic study results. METHODS An anonymous survey was conducted of patients undergoing outpatient radiologic imaging studies and their referring physicians. The voluntary surveys elicited responses regarding preferences on a 5-point Likert scale (Strongly disagree, disagree, neutral, agree and strongly agree), as well as indicated by responding yes or no to specific questions. RESULTS 368 patients completed the survey. 81.5% of patient responders preferred all results communicated from the radiologist within the same day. 65.9% of patients preferred same day results if normal vs 65.8% if abnormal. 34.5% preferred to wait and review normal results with the referring physician. 41.5% preferred to wait and review abnormal results with the referring physician. It was found that patients were more likely to strongly agree with waiting to review results with the referring physician if the results were abnormal, as opposed to normal (18.5% vs 11.9%, respectively; P < 0.014). 64% of physicians did not want results reviewed with their patients; 87.6% did not want a report sent to the patient by the radiologist, even after report was sent to their office. 66.4% of patients surveyed indicated that waiting for imaging results gives them anxiety. CONCLUSIONS 58-82% of patients preferred same day radiologist communication of their results while 55-87.6% of physicians did not prefer same day radiologist communication of results directly with their patients. 66.4% of patients surveyed indicated that waiting for imaging results gives them anxiety.
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Affiliation(s)
- Janice N Thai
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America.
| | - Raina Josemon
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Shrita Smith
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Jose Morey
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Cristina P Sison
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Elliot Landau
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Nathan Chaya
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Steven Peti
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Marlena E Jbara
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - David Sarkany
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Mark Raden
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
| | - Arnold I Brenner
- Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America
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Edwards EA, Cote A, Phelps AS, Naeger DM. Parents of Pediatric Radiology Patients Prefer Timely Reporting and Discussing Results with Referring Providers. Acad Radiol 2020; 27:739-743. [PMID: 31420160 DOI: 10.1016/j.acra.2019.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/03/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES With the introduction of new communication channels, such as encrypted messaging and online electronic medical record patient portals, there are ever-increasing ways for patients and their families to access their medical information. While patient preferences regarding how they receive the results of their radiology examinations have been assessed in the adult population, there is limited data on parent preferences for pediatric radiology patients. MATERIALS AND METHODS The aim of this study was to determine how the parents of pediatric radiology patients prefer to receive the results of their child's imaging studies. The study design was an institutional review board-approved anonymous voluntary survey distributed to parents in a pediatric radiology waiting room. RESULTS Of the current possible ways to receive radiology results, most parents preferred to receive their child's radiology results from the referring doctor (65%). A minority of parents preferred to receive the results from a radiologist in-person (16%) or via the radiology report (16%). In multiple hypothetical scenarios, parents also preferred to receive radiology results from the referring doctor rather than the radiologist, with the single exception being when no subsequent appointment with the referring doctor was planned. When asked to prioritize the most important aspect of receiving radiology test results, most parents prefer having results available quickly (65%). CONCLUSION This survey suggests that in the pediatric radiology realm, efforts toward timely reporting will likely have a greater impact on patient satisfaction than prioritizing more in-person radiologist-patient communication.
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Affiliation(s)
- Emily A Edwards
- University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California
| | - Andre Cote
- Hofstra University, Department of Medicine, Long Island, New York
| | - Andrew S Phelps
- University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California
| | - David M Naeger
- Denver Health and Hospital Authority, University of Colorado School of Medicine, Department of Radiology, 777 Bannock St., MC0024, Denver, CO.
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Cox J, Graham Y. Radiology and patient communication: if not now, then when? Eur Radiol 2019; 30:501-503. [PMID: 31359123 DOI: 10.1007/s00330-019-06349-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/10/2019] [Accepted: 06/28/2019] [Indexed: 11/24/2022]
Abstract
KEY POINTS • Communication with patients in radiology is, in general, indirect using the referrer as a conduit. • Direct patient communication may be beneficial for radiology departments and radiologists to improve patient awareness about the nature of our role and also to provide correct and measured information about the nature and frequency of discrepancies in radiology.
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Affiliation(s)
- Julie Cox
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK. .,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK.
| | - Yitka Graham
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK.,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK
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Automatic Release of Radiology Reports via an Online Patient Portal. J Am Coll Radiol 2017; 14:1219-1221. [DOI: 10.1016/j.jacr.2017.04.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 04/22/2017] [Accepted: 04/28/2017] [Indexed: 11/20/2022]
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Bashshur RL, Krupinski EA, Thrall JH, Bashshur N. The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence. Telemed J E Health 2016; 22:868-898. [PMID: 27585301 PMCID: PMC5107673 DOI: 10.1089/tmj.2016.0149] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/10/2016] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. METHODS A selective review of the credible literature during the past decade (2005-2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. FINDINGS The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.
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Affiliation(s)
| | | | - James H. Thrall
- Department of Radiology, Massachusetts General Hospital, Harvard, Boston, Massachusetts
| | - Noura Bashshur
- University of Michigan Health System, Ann Arbor, Michigan
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Cabarrus M, Naeger DM, Rybkin A, Qayyum A. Patients Prefer Results From the Ordering Provider and Access to Their Radiology Reports. J Am Coll Radiol 2015; 12:556-62. [DOI: 10.1016/j.jacr.2014.12.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 12/16/2014] [Accepted: 12/18/2014] [Indexed: 11/16/2022]
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Morey JM, Haney NM, Schoppe K, Hawkins CM. Adding Value as Young Radiologists: Challenges and Opportunities, Part 1. J Am Coll Radiol 2015; 12:533-6. [DOI: 10.1016/j.jacr.2015.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/02/2015] [Indexed: 10/23/2022]
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Abstract
OBJECTIVE Today in the hospital setting, several functions of the radiology information system (RIS), including order entry, patient registration, report repository, and the physician directory, have moved to enterprise electronic medical records. Some observers might conclude that the RIS is going away. In this article, we contend that because of the maturity of the RIS market compared with other areas of the health care enterprise, radiology has a unique opportunity to innovate. CONCLUSION While most of the hospital enterprise spends the next several years going through the digital transformation converting from paper to a digital format, radiology can leap ahead in its use of analytics and information technology. This article presents a summary of new RIS functions still maturing and open to innovation in the RIS market.
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Safdar N, Shet N, Bulas D, Knight N. Handoffs Between Radiologists and Patients: Threat or Opportunity? J Am Coll Radiol 2011; 8:853-7. [DOI: 10.1016/j.jacr.2011.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 08/11/2011] [Indexed: 10/15/2022]
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Johnson AJ, Frankel RM, Williams LS, Glover S, Easterling D. Patient Access to Radiology Reports: What Do Physicians Think? J Am Coll Radiol 2010; 7:281-9. [DOI: 10.1016/j.jacr.2009.10.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Accepted: 10/12/2009] [Indexed: 10/19/2022]
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Insight From Patients for Radiologists: Improving Our Reporting Systems. J Am Coll Radiol 2009; 6:786-94. [DOI: 10.1016/j.jacr.2009.07.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 07/17/2009] [Indexed: 11/23/2022]
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Informatics methods to enable patient-centered radiology. Acad Radiol 2009; 16:524-34. [PMID: 19345892 DOI: 10.1016/j.acra.2009.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 01/06/2009] [Accepted: 01/07/2009] [Indexed: 11/23/2022]
Abstract
Informatics methods and systems in support of clinical care are well established in the health care enterprise. The new paradigm of patient-centered radiology creates new requirements and challenges that can be enabled by informatics. In particular, computer support can help referring physicians tailor their imaging requests to those procedures that would be most helpful for their patients'clinical context. Informatics methods can assist radiologists in recognizing important findings in images as well as helping them decide the best course of action for patients given the radiologic imaging results and other clinical data. Finally, informatics methods can help engage patients in their care by providing information about their imaging procedures and results. All of these informatics technologies share in common the ability to bring together critical knowledge filtered according to the specific requirements of patients undergoing radiologic imaging, a key component of patient-centered radiology. The goals of this article are to review the opportunities for informatics in supporting patient-centered radiology, to demonstrate the potential utility of these methods, and to point radiologists to the ways that informatics will help them provide care that is tailored to each patient.
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Continue Drawing Back the Curtain: Educating the Community About Radiology. AJR Am J Roentgenol 2009; 192:1388-90. [DOI: 10.2214/ajr.08.1930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Design, implementation, and assessment of a radiology workflow management system. AJR Am J Roentgenol 2008; 191:321-7. [PMID: 18647896 DOI: 10.2214/ajr.07.3122] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this article is to describe the development, launch, and outcomes studies of a paperless workflow management system (WMS) that improves radiology workflow in a filmless and speech-recognition environment. MATERIALS AND METHODS The WMS prioritizes cases automatically on the basis of medical and operational acuity factors, automatically facilitates communication of critical radiology results, and provides permanent documentation of these results and communications. It runs in parallel with an integrated radiology information system (RIS)-PACS and speech-recognition system. Its effects on operations, staff stress and satisfaction, and patient satisfaction were studied. RESULTS Despite an increase in caseload volume after the launch of the WMS, case turnaround times, defined as the time between case availability on PACS and signing of the final radiology staff interpretation, decreased for all case types. Median case turnaround time decreased by 33 minutes (22%) for emergency department, 47 minutes (37%) for inpatient, and 22 minutes (38%) for outpatient radiology cases. All reductions were significant at a p value of < 0.05. Interruptions were reduced, consuming an estimated 28% less radiology staff time, after implementation. Patient perceptions of radiology service timeliness showed modest improvement after the WMS was implemented. Staff satisfaction showed no significant change. CONCLUSION There is room for improvement in radiology workflow even in departments with integrated RIS-PACS and speech-recognition systems. This study has shown that software tools that coordinate decentralized workflow and dynamically balance workloads can increase the efficiency and efficacy of radiologists. Operational benefits, such as reduced reading times, improvements in the timeliness of care (both actual and as perceived by patients), and reduced interruptions to radiologists, further reinforce the benefits of such a system. Secondary benefits, such as documenting communication about a case and facilitating review of results, can also promote more timely and effective care. Although use of the system did not result in a substantial improvement in staff perceptions, neither did it reduce their satisfaction, suggesting that these operational improvements were not achieved as a trade-off against the quality of the work environment.
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Brenner RJ. To err is human, to correct divine: the emergence of technology-based communication systems. J Am Coll Radiol 2007; 3:340-5. [PMID: 17412078 DOI: 10.1016/j.jacr.2006.01.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Indexed: 10/24/2022]
Abstract
An increasing emphasis has been placed on the importance of timely communication of imaging results, especially to the extent that clinical management decisions are modified by the information. Various methods of transmitting results have been proposed and developing technology can now be applied to helping to ensure the timely receipt of such results in a busy clinical environment. Stratifying levels of urgency, ensuring redundancy of potential recipients of such information, and the ability to assess desired benchmarks are objectives that involve many stakeholders, including radiologists, treating physicians, and institutions. An enterprise approach to this challenge, including commercially available systems, offers a potentially cost-effective solution that addresses both risk management and quality improvement goals.
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Affiliation(s)
- R James Brenner
- University of California, San Francisco, Mt. Zion Medical Center, San Francisco, CA 94115-1667, USA.
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