It’s all about the patient. This is an idea that seems obvious to most at first blush. After all, why would anyone seek a job in healthcare if not to help patients? But sometimes organizations need to rethink their processes to evaluate whether the patient is truly at the center of what they do.
That’s why patient-centered healthcare has become such a focus in healthcare. Within radiology, patient-centeredness is certainly a common rallying cry at educational conferences and is one of the core ideas behind the American College of Radiology’s Imaging 3.0 campaign. It means making sure every scan is appropriate, radiation dose levels are as low as they can be, and that every patient receives their results as quickly as possible.
Last year, we highlighted the work of five organizations who had recently undergone a quality improvement project or upgraded technology that benefited patient care. This year, once again with the help of the ACR, the Health Imaging editorial team selected five sites for their work on improving patient-centered care, whether that meant improving processes in delivering mammography results or leveraging decision support to ensure each scan is appropriate.
Read on to see descriptions of the projects from the stakeholders themselves:
Cathrine E. Keller, MD.
Same Day Mammography Results: Lake Medical Imaging, Leesburg & The Villages, Fla.
Background: Women undergoing screening or diagnostic mammography await the results anxiously, often suffering a needless delay. We provide same day results to all patients: each women leaves with her lay letter explaining her mammography result, and an appointment for the following year. If the woman needs any additional mammography images or ultrasound, it is performed the same day. If a biopsy is necessary, she has the procedure explained prior to leaving, has an information handout and a contact person’s phone number and for questions. Biopsies are performed within five business days, unless there are extenuating circumstances.
Project: To achieve same day results, we staffed a radiologist in the women’s center reading mammograms contemporaneously. Upon completion of patient intake history and imaging, the gowned patient goes to an exam room. The radiologist reads the mammogram, completes the lay letter, then meets the patient for a breast examination and results. To allow the radiologist to do this, the only other reading responsibilities are the bone films, DEXA, and breast ultrasound and breast MRI.
We revamped the work area and gowned waiting to place the reading room in the midst, with the exam room immediately adjacent to reading room and mammography units across the hall from gowned waiting. We changed procedures with scheduling and the file room to obtain outside prior mammograms before the patient arrives for the appointment in 85 percent of cases.
Results: Using this approach, our satisfaction scores on social media all went to 4.5 /5 or 5/5, and our patient satisfaction surveys went from 4/5 to 5/5. Referring physician satisfaction rose from 4/5 to 5/5. Our volume of mammography has steadily increased even though nationally there was a dip. Mammography volume increased 7 percent, biopsy volume increased 5 percent, and both breast MR and ultrasound increased proportionately.
Cloud-Based Imaging: Children’s of Alabama, Birmingham, Ala.
Background: Located in Birmingham, Children’s of Alabama is the third largest pediatric medical facility in the U.S. and the only standalone pediatric hospital and Level I pediatric trauma facility in Alabama. With more than 375 beds, cribs and bassinets, Children’s receives patients from every Alabama county and nearly every state in the nation.
With a large referral network, it was imperative that Children’s physicians were able to quickly and reliably view, share and store the large amount of medical images it received for its patients. However, one of the hospital’s primary referral providers regularly sent CDs that were unreadable or contained corrupt files. This problem wasn’t isolated, either. In fact, 20 percent of CDs were unusable, causing frustration and workflow disruption for physicians, particularly trauma surgeons. In return, when a file was unusable, young patients would have to be rescanned. These rescans not only cost precious time, but also exposed patients to additional radiation—simply because the original image could not be read.
At the time, Children’s also did not have 24/7 radiology attending