Referring physician input guides CT colon report format

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CHICAGO—To find out what a customer wants, sometimes it’s simply best to just ask. Although this approach may seem painfully obvious, when it comes to clinician-to-clinician service offerings, this often unexplored strategy can provide a better quality of medical communication, as well as deliver improved patient care.

 “A customer-centric survey allowed us to develop a better way to deliver CT colonography (CTC) reports to our referring physicians,” said Sharon Burton, MD, from the Mayo Clinic in Rochester, Minn., who spoke at the 94th annual meeting of the Radiological Society of North America (RSNA).

As CTC gains wider acceptance as an effective and less-invasive exam for colon cancer screening—opening the possibility of universal reimbursement for the exam alongside traditional colonoscopy—clear and efficient communication of results will be of paramount importance to referring clinician satisfaction.

Burton shared the results of an initiative undertaken by Mayo to develop a structured report format for the communication of CTC results to its referring clinicians.

The facility based its CTC structured report format on the basis of a consensus proposal for CTC reporting first published in the journal Radiology (July 2005). In this work, members of the Working Group on Virtual Colonoscopy suggested that CTC reports follow format elements similar to the precedent of the mammography Breast Imaging Reporting and Data System, or BI-RADS, schema.

Burton’s group used the “C-RAD” proposals from the working group as a starting point for their report format. Rather than foisting C-RAD on their referring physician base, they actively sought their input to fine-tune the structured report’s format.

“Responses were ranked by frequency to identify key reporting preferences of referring physicians,” Burton said. “A new CTC report format was developed using these preferences and components of the C-RAD proposal on CTC reporting. In addition, an on-line survey comparing referring physician satisfaction with old and new report formats was created.”

The team reconfigured the C-RAD report format to present colonic findings, in all capital letters, first. A paragraph break followed and extracolonic findings were presented next. Technique followed another paragraph break, and comprised the third element presented in the report. The new format was then sent out, along with the traditional format currently in place at the facility to a broad group of referring clinicians.

She reported that nine questions reflecting key reporting preferences were asked using a Likert rating scale and written comments. The survey was then sent by email to 82 physicians and the Mayo group performed an analysis of their responses by calculation of satisfaction scores and Chi-square test.

Burton said that respondents preferred the new format over the old with significant differences in satisfaction scores in eight of nine questions.

“This survey method has guided development of a CTC structured report that better satisfies the needs of referring physicians,” she said. “Serving the needs of the referring physician translates to better service for the patient. This survey method may be useful for other quality improvement projects in radiology.”