Effective leadership is vital to critical test results communication

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SEATTLE—Closing the loop on the communication of critical test results in medical imaging has been identified as a key safe practices goal and is likely to become an important quality metric for CMS, which could impact payments to caregivers, according to three presentations made during the Society of Imaging Informatics in Medicine (SIIM) annual meeting in the SIIM U Section 4 session “Communicating Results.”

Ramin Khorasani, MD, MPH, of Brigham & Women’s Hospital, Harvard Medical School, Boston, defined the functional elements to successfully closing the communications loop in context of Joint Commission on Accreditation of Hospital Organizations (JCAHO) requirements in his presentation “Communication of Critical Test Results and the National Patient Safety Goals: What You Need to Do.”

“The first thing we need to do is to identify who it is that you need to communicate with,” Khorasani said. Accurate targets such as requesting physicians, care providers and care team members must be clearly defined. While outlining these definitions might seem trivial, the truth is that they are not embedded in the day-to-day workflow of imaging centers, facilities and hospitals, he said.

An important target to remember is the patient. The role of the patient in the communication loop is that of the receiver of the communication results. “We have not truly figured this out yet, but at the end of the day, the patient is the best repository of this information—the best person ensuring actions are followed up on.”

Another functional requirement is to define and categorize critical test results, to create results stratification, he noted. Additionally, organizations need to look at the timeliness of notifications and results and how they are communicated across the enterprise; ensure communication is clear and followed up on; document all who, what, when, and where, making it auditable and part of the medical record; and measure communications results performance. “You can’t improve what you don’t measure,” Khorasani said.

He said that organizations can accomplish this in the following ways: build a team; define policy and procedures; communicating; measure performance; implement procedures; measure performance again; and control gains.

“There is not a single IT solution that can fulfill the roles here,” he said. “We need a systems approach suboptimal process, but can’t wait. We must start now so that we will improve with technology.”

“It is all about people who can manage change—that is what critical test results management boils down to,” he concluded.