Behind the Curtain

Ohio radiologists collaborate with a patient advocate to implement a direct results delivery program that decreases patient anxiety.

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When David C. Mihal, MD, then diagnostic radiology resident at the University of Cincinnati Medical Center, began working on his practicum for the Radiology Leadership Institute® he knew he wanted to use the opportunity to make a real difference for patients and families.

But before Mihal could improve the patient experience, he needed a better understanding of how patients and families perceived in radiology.

Mihal turned to Dianne Hater, patient and family advocate in the Cincinnati Children's Hospital's radiology department, to help him focus his efforts on meaningful change in patient care. "I approached Dianne because she was deeply entwined in patient and family relationships at Cincinnati Children's, and I wanted to make some sort of real difference that would directly benefit them," Mihal says.

Hater, who became an advocate after navigating the healthcare system during her own daughter's illness, began talking with the hospital's frontline staff (including technologists, registration personnel, patient advocates, and child-life specialists) about their interactions with patients and families who had undergone imaging. From these conversations, Hater found that many patients and behind curtain 1families were noticeably nervous during and after their imaging exams, and the technologists often felt helpless because they were unable to share results with patients and families.

Recognizing an opportunity to improve the patient experience through better communication, Mihal initiated a direct-results-delivery pilot project that would allow patients and families to review their exam results with a radiologist immediately after image acquisition. Since its inception in 2015, the project has drawn praise from patients and families, with 92 percent providing positive feedback on surveys. In addition, 84 percent of participating radiologists and technologists reported increased job satisfaction — leading the department to adopt it is an ongoing initiative.

A Face to Radiology

To get the program off the ground, Mihal approached Brian D. Coley, MD, radiologist-in-chief and professor of radiology and pediatrics, and Bernadette L. Koch, MD, pediatric neuroradiologist and associate chief of academic affairs. Coley and Koch were both excited for the opportunity to reemphasize quality patient care and to give patients a chance to speak directly with radiologists. “This program provides patients with more positive experiences in radiology and puts a human face to the profession, helping patients understand the important role that radiologists play in their care,” Coley says.

In addition to humanizing radiology for patients, the project also offered the chance for the department’s radiologists to connect with their patients and feel more fulfilled as a result, says Alexander J. Towbin, MD, associate chief of clinical operations and radiology informatics and pediatric radiologist at Cincinnati Children’s Hospital. “Oftentimes, as radiologists, we get detached from our patients. We are looking at pictures all day. We see the body parts and the disease, but we don’t always see the child on the other side of the picture,” Towbin says. “Speaking with patients is an excellent reminder that we are diagnosing real people.”

“Speaking with patients is an excellent reminder that we are diagnosing real people.” - Alexander J. Towbin, MD

A New Beginning

Mihal began rolling out the project slowly and purposefully, in part to win support from his colleagues, many of whom were initially concerned that they would be unable to keep up with the volume of patients opting for the service. In fact, only seven of the department’s 40 radiologists volunteered to participate in the project at first. “As the program expanded and faculty saw how little time it actually took, it was much easier to get more radiologists involved,” Koch says.

To get patients involved, technologists simply asked whether patients wanted to speak with the radiologist. If the patient and family opted for a consultation, the technologist located a radiologist from the volunteer pool, assigned the study to that radiologist, and informed the patient that the radiologist would be in soon to discuss the results. The radiologist would then read the study and deliver the results directly to the patient in the exam or consultation room. Wait time for the patient was typically less than 10 additional minutes.

In feedback surveys, patients and families were overwhelmingly satisfied with the service and reported feeling relieved and at ease after receiving their results from a radiologist. Comments included, “Made my day!” and “It immediately eased my mind and assured me everything was OK to return to work and school.”

As an imaging technologist and quality improvement coach at Cincinnati Children’s Hospital, Erin Adkins values the opportunity to help lessen the anxiety patients and families often feel. “When you see patients and families enter the room who are visibly nervous, you can immediately put them at ease by offering to find a radiologist to speak with them,” she says. “A lot of what we do is so quick, and this provides some closure and more connection with the patients. It gives you satisfaction in knowing that you are part of improving the patient experience.”

In addition to increasing job satisfaction, most of the radiologists and technologists involved in the program report little increase in their workloads as a result. “If anything,” Coley says, “spending time with patients minimizes physician burnout. It personalizes what radiologists do and allows them to connect more directly with patients.”

Plans for the Future

Cincinnati Children’s Hospital has now integrated the pilot project into the regular workflow as an ongoing program for outpatients undergoing imaging. “There’s no doubt how much patients and families appreciate it when they can get their results and have their questions answered immediately,” says Hater. “It saves them from so much worry and allows them to move more quickly toward treatment and healing. This kind of patient-centered care is the way of the future, and radiologists are well positioned to lead this effort.”

By Chelsea Krieg, freelance writer, ACR Press

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