The researchers wanted to address a number of issues in their quality improvement project, such as the perception of a widening disconnect between radiologists and referring care providers due to the increasing reliance on electronic communication and digital image access. They also wanted to address a belief that text communication may not effectively convey the full range of thoughts possible with an in-person discussion, as well as an interest in bringing the advantages afforded by a multidisciplinary "tumor board" to the acute care setting, according to senior author Dr. Matthew Davenport.
The team, which also included presenting author Dr. Elliot Dickerson, also believed that the question of greatest interest to a referring physician is likely better explained in person, and that more accurate information inevitably will lead to a more accurate diagnosis, Davenport said.
Furthermore, "modern radiology consults are inherently one-step processes (get exam, read exam, forget exam) that do not permit an exchange of ideas; a one-step exchange of information is unable to account for new or undiscovered information that might alter decision-making, whereas the multistep process of a conversation permits the development of a shared and more accurate mental model of a patient's condition," Davenport told AuntMinnie.com.
After instituting in-person communication between subspecialized radiologists and acute care surgeons, the researchers found that attending surgeons had substantial changes in their diagnostic impression in approximately 40% of cases. It also led to substantial changes in operative decision-making in approximately 15% to 20% of cases.
"This includes the decision to operate or not, and the decision about how to operate -- i.e., where to put the incision," Davenport said. "This large fraction of substantial management changes was surprising and gratifying."
Surgeons and trainees want this in-person communication, he said.
"The service has received glowing reviews and is routinely described as one of the top three educational opportunities on the surgical service," Davenport said.
Learn more by stopping by the Hardcopy Backboard at Lakeside Learning Center on Monday.
