Best Practices for Patient Engagement
The patient is the center of the healthcare universe, and imaging departments and practices are working ever harder these days to prove patient-centeredness is their No. 1 mission, while the American College of Radiology’s (ACR’s) Imaging 3.0 campaign strives to improve patient engagement
With the help of the folks at ACR, the Health Imaging editorial team collected piles of electronic nominations for the inaugural Patient-Centric Imaging Awards. We were thoroughly impressed with the myriad creative and detailed projects to address the challenges of patient engagement in imaging.
The projects run the gamut from department re-design to communication to image sharing. However, some common themes stand out. Each organization identified and focused on a specific problem at their institution. They engaged multiple stakeholders, including patients, and ensured referring physician buy-in. They measured results and, most importantly, approached their project as a process rather than a product.
Read on to learn more about these projects, as told by the stakeholders themselves.
Cincinnati Children’s Hospital Communicating Difficult News
|Cincinnati Children's Hospital main campus.|
Background: Radiologists are often tasked with making life-changing diagnoses. In the past, we would dictate a report and call the referring provider. The patient and family would talk with the physician hours or days later and then return to the hospital to initiate therapy.
Objective: The radiology department sought to create a defined process for communicating difficult news directly to a patient or family.
Methods: Difficult news guidelines were created to address the needs of all stakeholders. When radiologists initiate the process, they first contact the referring provider, notify him or her of the findings and ask how the results should be communicated. The ordering provider has the option of in-person communication, phone communication with the radiologist in the room to help answer questions or results delivery by the radiologist.
A non-physician point person is designated to help patients and families by moving them to a multipurpose room if needed, transcribing notes, checking on the patient and interacting with young patients or siblings while results are discussed with parents.
The radiologist or ordering provider reviews the findings with the family, answers questions and discusses the next steps. After the conversation, the radiologist helps to coordinate the agreed upon next steps, including further imaging or admission.
Results: The radiology department implemented the difficult new guidelines. All radiologists, technologists and child life specialists attended or viewed a recorded lecture. All radiologists were required to institute the difficult news process at least one time during the course of the year. If the radiologists did not have an opportunity to employ the process, they were required to undergo simulation-based training. Overall, the program has received positive feedback from families, ordering healthcare providers and radiologists.
East West Health Centers/Invision Sally Jobe Breast Network Knowledge is Power: Increasing Awareness about Personalized Breast Cancer Risk
|Radiology department staff at Invision Sally Jobe|
Background: In 2009, Invision Sally Jobe (ISJ) implemented a process by which breast imaging patients were screened for their lifetime risk to develop breast cancer in order to recommend annual breast MRI screening as an adjunct to mammography. Personal and family history characteristics also were checked to indicate the need for a genetic counseling consultation. Personalized recommendations were communicated to the referring physician via breast imaging reports, but patients were not receiving the information directly.
During 2009, the center saw an increase in breast MRI screening volume and the volume of office visits with its genetic counselor, but the increase was more modest than expected. Additionally, ISJ’s genetic counselor noticed a trend of patients who were unaware of their high risk status and the options available to them, despite this information being communicated to the referring physician via the breast imaging report. At the same time, the idea of direct-to-patient communication about breast density was gaining support in certain states.
Objective: ISJ saw an opportunity to involve patients more extensively in the decision to consider breast