Ring Ring Ring! Characterising Telephone Interruptions During Radiology Reporting and How to Reduce These (original) (raw)
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Reporting of clinically significant events represents an important mechanism by which patient safety problems may be identified and corrected. However, time pressure and cumbersome report entry procedures have discouraged the full participation of physicians. To improve the process, our internal medicine training program developed an easy-to-use mobile platform that combines the reporting process with patient sign-out. Between August 25, 2011, and January 25, 2012, our trainees entered clinically significant events into i-touch/i-phone/i-pad based devices functioning in wireless-synchrony with our desktop application. Events were collected into daily reports that were sent from the handoff system to program leaders and attending physicians to plan for rounds and to correct safety problems. Using the mobile module, residents entered 31 reportable events per month versus the 12 events per month that were reported via desktop during a previous 6-month study period. Advances in information technology now permit clinically significant events that take place during "off hours" to be identified and reported (via handoff) to next providers and to supervisors via collated reports. This information permits hospital leaders to correct safety issues quickly and effectively, while attending physicians are able to use information gleaned from the reports to optimize rounding plans and to provide additional oversight of trainee on call patient management decisions.
Preventing communication errors in telephone medicine
Journal of General Internal Medicine, 2005
Errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Similarly, training in telephone medicine skills is limited; only 6% of residency programs teach any aspect of telephone medicine. Increasing familiarity with common telephone challenges with patients may help physicians decrease the likelihood of negative outcomes. We use case vignettes to highlight communication errors in common telephone scenarios. These scenarios include giving sensitive test results, requests for narcotics, managing ill patients who are not sick enough for the emergency room, dealing with late-night calls, communicating with unintelligible patients, and handling calls from family members. We provide management strategies to minimize the occurrence of these errors.
Journal of the American College of Radiology : JACR, 2018
The aim of this study was to evaluate radiologists' experiences with patient interactions in the era of open access of patients to radiology reports. This prospective, nonrandom survey of staff and trainee radiologists (n = 128) at a single large academic institution was performed with approval from the institutional review board with a waiver of the requirement to obtain informed consent. A multiple-choice questionnaire with optional free-text comments was constructed with an online secure platform (REDCap) and distributed via departmental e-mail between June 1 and July 31, 2016. Participation in the survey was voluntary and anonymous, and responses were collected and aggregated via REDCap. Statistical analysis of categorical responses was performed with the χ test, with statistical significance defined as P < .05. Almost three-quarters of surveys (73.4% [94 of 128]) were completed. Staff radiologists represented 54.3% of survey respondents (51 of 94) and trainees 45.7% (43 ...
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Clinical Radiology, 2006
AIM: To evaluate the radiologist on-call clinical workload of an inner-city acute teaching hospital. MATERIALS AND METHODS: Data were collected prospectively from a 9-week assessment of the workload of the radiologists on-call at our Trust. Data collection was undertaken using a questionnaire-based survey detailing the date and time of request, and where appropriate, the imaging examination performed. The referring clinician's grade and speciality were also recorded. The results obtained were compared with a similar study carried out in 1996.
Improving Responsiveness to Patient Phone Calls
Journal of Patient Experience
Optimal patient-physician communication in the outpatient clinical setting is critical for safe and effective patient care. Keeping track of multiple patient telephone messages can be difficult and hazardous if a structured system is not in place. A multidisciplinary group at Hershey Medical Center developed a standardized approach for addressing patient telephone calls at their outpatient surgical clinics. This program was designed to improve the patient experience by providing a realistic time frame for phone calls to be returned and requests fulfilled. Additionally, this system permitted phone calls to be tracked and documented appropriately and allowed for prioritization of urgent and emergent messages. Our intent for this program was to close potential gaps within the communication chain at our outpatient surgical clinics, improve overall communication between clinicians and their patients, and improve both patient and employee satisfaction.
Introduction: Hist orically, t here has been no obj ect ive m et hod of m easuring t he t im e required for radiologist s t o produce report s during norm al work. We have creat ed a t echnique for sem i-aut om at ed m easurem ent of radiologist report ing t im e, and t hrough it produced a robust set of absolut e t im e require-m ent s and relat ive value unit s for consult ant report ing of diagnost ic exam i-nat ions in our hospit al. Methods: A large sam ple of report ing t im es, recorded aut om at ically by t he Radiology I nform at ion Syst em (COMRAD, Soft ware I nnovat ions, Christ-church, New Zealand) along wit h t he descript ion of each exam inat ion being report ed, was placed in a dat abase. Analysis was confi ned t o diagnost ic report ing by consult ant radiologist s. A spreadsheet was produced, list ing t he t ot al num ber and t he frequency of report ing t im es of each dist inct exam ina-t ion. Out liers wit h except ionally long report t im es (m ore t han 10 m in for plain radiography, 30 m in for ult rasound, or 60 m in for CT or MRI wit h som e except ions) were culled; t his rem oved 9.5% of t he t ot al. Com plex CTs requiring separat e workst at ion t im e were assigned t im es by consensus. The m edian t im e for t he rem ainder of each sam ple was t he assigned absolut e report ing t im e in m inut es and seconds. Relat ive value unit s were calculat ed using t he report ing t im e for a single view depart m ent chest X-ray of 1 m in 38 s including verifying a report m ade using speech recognit ion soft ware. Results: A schedule of absolut e and relat ive values, based on over 179 000 report s, form s Table 2 of t his paper. Conclusions: The t echnique provides a schedule of report ing t im es wit h reduced subj ect ive input , which is m ore robust t han exist ing syst em s for m easuring report ing t im e.
Quality of radiologists’ communication with other clinicians—As experienced by radiologists
Patient Education and Counseling, 2015
Mutual understanding in inter-professional communication is of paramount importance in health care [1]. With the introduction of electronic communication, traditional inter-professional communication is challenged. This is particularly evident in radiology, where communication of radiological images and reports now can be achieved electronically, based on digital picture and archiving systems (PACS) [2]. Thereby, images and reports can be reached instantly and simultaneously in e.g. surgical theatres, wards and outpatient clinics, and at remote sites outside hospitals. This is in sharp contrast to the traditional way of conveying imaging results, showing images on light-boxes and storing the only copy of the analogue film in the radiology file room. In parallel, many radiology departments strive for ''paper-free'' communication with clinicians, replacing paper referral forms with electronic referrals (and reports). PACS has clearly facilitated technical communication of imaging data [2], and also impacts work routines in radiology [3]. However, it has also been shown that consultations with radiologists decreased when hard copy films were replaced by workstations [4], but reports on effects on communication between radiologists and referring clinicians are conflicting [5]. The other aspect of inter-professional communication relates to its information value. The quality of communication from referring clinicians to radiologists has significant impact on clinical patient handling and safety [6-10]. Thus, request forms with adequate clinical information are essential to guide the radiologist and technician in planning and performing the examination and to obtain a correct diagnosis [11] and a clinically useful radiology report [12]. A previous study showed that of 100 request forms sent for MRI, 63% contained poor or insufficient information [13]. Inadequate communication of clinical data from referring clinicians to radiologists may have significant impact on diagnosis, cost and