Stanford’s radiology department experiences the power of patient input

Envisioned by the Institute of Medicine back in 2001 and systematized by the Joint Commission five years later, PFACs—patient and family advisory councils—are now a fixture in most U.S. hospitals. Scope, mission and vision vary widely, but these groups’ essential aim is tapping the customer’s perspective in order to improve everything from waiting-room design to EMR selection.

Considering the progress already made along these lines, radiology departments would do well to get more proactive about inserting themselves into the PFAC equation, suggest the authors of a review article published July 10 in the American Journal of Roentgenology.

“In radiology, the utilization of patient advisors is a relatively untapped resource for integrating methods that promote a patient-centered environment,” write Karin Kuhn, MD, and colleagues, all members of the radiology department at Stanford Health. “Like patient advisors in the greater hospital community, patient advisors in radiology can be called on for virtually any issue related to the patient experience; clinicians often simply need to call their local PFAC representative to start the conversation.”

To illustrate the possibilities, the team offers a brief case study reflecting on Stanford radiology’s use of the PFAC model to decrease patient wait times in the breast imaging department.

They describe how the project was initiated by a breast cancer survivor. The patient’s initial participation came in the form of negative feedback sent via email: She was understandably distressed over a long wait before she could come in for surveillance imaging.

Her complaint “was recognized as an opportunity for patient-directed process improvement,” the authors write, adding that the patient stepped up to serve as patient advisor on a wait-reduction workgroup whose other members soon included a radiologist, a technologist, a marketing specialist and a medical assistant.

Continually updated communications

Between June and October of 2015, the group collected data on average wait times for diagnostic and procedural appointments both at baseline and after the implementation of specific process improvements.  

These included ensuring that exam protocols were in place before scheduling patients, changing the logistics of the consent process and increasing the flexibility for same-day appointments by creating protected time in the schedule, the authors report.

“Additionally, based on feedback from the patient advisor, the group implemented a patient communication board in the waiting room that provided an estimate of the average wait time beyond the scheduled appointment time and that was updated every 30 minutes,” write Kuhn et al.

“The patient advisor explained the loss of control often felt by patients undergoing cancer treatment, and the simple change in communication imparted by this tool served as an effective method of preserving patient control and overall satisfaction with the experience.”

All the service in one-third of the time

The salient outcome was the cutting of average wait time from half an hour to just 10 minutes.

This was based on the team’s comparison of average performance during 34 days before the first intervention and 19 days after stabilization following the final intervention.

In their conclusion, the authors stress their experience validating the view that patients are “ready and willing to voice valuable opinions that can assist healthcare providers in optimizing current methods and represent a resource of great potential, a notion that we in radiology are just beginning to appreciate.”

“PFACs are a particularly powerful method of patient and family engagement that can be used in effecting meaningful change in practice,” they add. “In the era of value-based care, it is essential that radiologists actively engage with patients to improve efficiency, reduce expenditures and maximize patient satisfaction.”