There's a lot of talk about patient safety in medical imaging and managing the risks of medical radiation. Both are important concerns, but are they what patients are most focused on when they undergo an exam? Perhaps not, according to an August 22 talk at the American Board of Radiology Foundation's (ABRF) national medical imaging summit in Bethesda, MD.
Strategies developed by national radiology organizations for safe and appropriate medical imaging emphasize providing patients with information about the quality and safety of the actual imaging equipment and the facility. But patients are more interested in basic information, according to presenters Dr. Jay Pahade, of Yale University School of Medicine, and Dr. Andrew Trout, of Cincinnati Children's Hospital Medical Center.
"Patients want to know the basics -- the name of the test, how to prepare, and the results," Pahade and Trout said. "They're less concerned with radiation dose, credentials, and who provides the information."
Adult and pediatric surveys
In their presentation, Pahade and Trout shared results from two surveys they performed that included responses from 23 members of patient advocacy groups at Cincinnati Children's Hospital, Yale Smilow Cancer Center, Yale General Hospital Group, and Yale Pediatric Group. One of the surveys was aimed at adult imaging, with the other targeted pediatric imaging.
"These were vocal, motivated groups with interest in improving care and patient experience," Pahade and Trout said.
The majority of respondents wanted information about the exam before undergoing it, stating that knowing what to expect makes the process easier, according to Pahade and Trout. What kind of information? Most respondents, both for the adult and pediatric surveys, wanted to know what kind of preparation would be needed (an IV, or oral contrast).
Dr. Jay Pahade from Yale University.For adult exams, the second piece of information desired was how long it would take to get results, followed by why the test was being done. For pediatric imaging, these two priorities were reversed.
Survey participants' first preference as to who would deliver their exam results was for knowledgeable staff, followed by the ordering doctor and then the radiologist. In terms of how respondents wanted to receive the information, on the adult side, the majority preferred to receive it in written form; second and third preferences were verbally and by phone, respectively. On the pediatric side, there was a tie between written and verbal delivery of the information, followed by receiving it by phone.
"Survey respondents said they wanted to interact with a knowledgeable, friendly person who could diffuse any fears and treat the patient with compassion and dignity," Pahade and Trout said. "They also stated that they thought the information about the exam should come in written form, with an opportunity to discuss before the test with a qualified person."
Respondents for both the adult and pediatric surveys said they wanted the information about the exam one to seven days in advance. After the exam, the majority of participants for both surveys wanted to know either the results or how long they would have to wait for the results.
"Patients want the results as soon as possible," Pahade and Trout said.
Pahade and Trout also found that most survey respondents had sought information about the test themselves from a hospital website, Google, or a medical site such as WebMD.
"No one mentioned seeking information about tests from RadiologyInfo.org," they said.
Survey participants stressed that they wanted exams to be as expeditious as possible, especially for pediatric tests; they wanted as much information as possible before the exam about what it would involve, such as whether it would hurt; and they wanted a clear picture of what would happen during the exam and not to be left alone for long periods.
The survey asked participants to rate the following questions suggested by national radiology groups and leaders to help patients be informed about their exam:
- What is the name of the test to be performed?
- Does it involve ionizing radiation?
- How will the test improve my care?
- Are there alternatives that do not use radiation that are equally good?
- Will my child receive a "kid-size" dose?
- Is the doctor reading the exam certified by the American Board of Radiology?
- Is the facility where I will have the exam accredited by the American College of Radiology?
Pahade and Trout found that in both surveys, participants wanted to know the name of the imaging test and whether it would improve care. They were not as interested in how much radiation the test would impart, whether the doctor performing the exam was American Board of Radiology certified, and whether the site where the test was performed was American College of Radiology certified.
The researchers conceded that their study was small and the participants were unique, consisting of people who were interested in improving healthcare delivery and who had a chronic illness or were helping to care for someone who did, rather than a general population. But the study findings are instructive, Pahade and Trout said.
"We need to get the patient-centered piece under our belt first before we work on the bigger, more complex issues," they said.
