RSNA: Barriers to reporting critical imaging results still exist
CHICAGO--While efforts to report critical imaging results are eventually successful, barriers remain that often prevent effective and efficient communication, according to a paper presented Tuesday at the Radiological Society of North America (RSNA) annual meeting.

Paul Thacker, MD, a radiologist at the Mayo Clinic in Rochester, Minn., and colleagues retrospectively reviewed the reports of 4,323 chest CT studies (377 positive for pulmonary embolism [PE]) performed to exclude PE between August 2007 and September 2009.

The reports of positive PE were audited and researchers found that direct communication occurred within one hour of image acquisition in 86 percent of the cases.

The authors also sent a survey to the radiologists in the department asking them for their opinions on communication barriers. According to the survey results, the most commonly stated barrier to efficient communication was the unavailability of the ordering physician (40 percent).

“This occurs basically in two settings,” said Thacker. “Either the ordering physicians didn’t call back in an hour or they didn’t return the page at all.”

The other major barrier to efficient communication was unwillingness to take responsibility for the patient (24 percent). Other barriers to communication included cases in which the ordering physician wasn’t the actual provider (18 percent) and lack of accurate contact information (7 percent).

Thacker said that after reviewing the results of the survey, his department took some steps to try to increase communications effectiveness.

“First of all, we made our physicians aware of a program that was already in place used by laboratory medicine,” said Thacker. “When laboratory services has a critical finding, they have a call center where they utilize operators to take the information down, record the provider to whom the findings will be sent, and once they find the provider, they call you back.”

He said his department also added a service pager that’s staffed daily, 24 hours a day, and has examined the techniques of radiologists who have had 100 percent compliance as well as those who have had poor compliance in order to develop some best practices. The result, Thacker said, is that there has been a steady, incremental increase in communication effectiveness.