Building Trust Between the Patient and Radiographer in a Digital World

ECR, ECR 2019, patient care, Patient-centered care, Radiographer

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ECR sessions offer studies and suggestions for keeping the patient in focus.

There were 80 sessions on artificial intelligence at ECR 2019. However, the topic that surfaced often in conversations and the sessions I attended on day one was the very low-tech but all-important human factor. The “humans” being both the patients receiving the care and the radiologists and radiographers who care for them.

“Keeping the patient and their care at the front of our attention is a focus for our association and for our radiographers. We have assured that the technology we use is the gold standard, but sometimes we leave the focus on the patient behind,” said Rodrigo Garcia Gorga, a radiographer and general secretary of Sociedad Espanola deGraduados y Tecnicos en Radiologia.

“Patients lose their identity quickly when they come in to the hospital environment,” said R. M. Strudwick in her presentation on “Value-Based Practice (VBP) Training for Radiographers.” Radiographers, like other healthcare providers, need to consider that a patient’s values are likely different from their own; and that their values will influence the patient’s decisions about their care.

Based on their research, Ms. Strudwick and her team created a handbook on the subject of Value-Based Practice with scenarios that demonstrate when values are unknowingly in conflict. Adopting a value-based practice might require a considerable mind shift for some radiographers. However, Ms. Strudwick suggested they start with small changes, such as smiling when greeting a patient. Additionally, ask a patient how you can work together to capture the best image. For example, if a patient is unable to stand, ask him/her for their input on how the position can best be achieved.

The power of paper in the radiographer/patient relationship

Ironically, in today’s digital age, written communications shared via paper documents can play a positive role in the radiologist/patient relationship.

In a study on “Informed Consent in Diagnostic Imaging: an Evaluation of Current Practice,” the research team conducted an audit of current practice regarding radiographers gaining informed consent within NHS diagnostic imaging departments throughout the United Kingdom.

The findings found that some radiographers felt awkward asking for signed permission. Although signed consent is a legal document, it should also be viewed as a common courtesy to extend to the patient and a way of building trust between radiographer and patient, said A. Ramlaul, Hatfield/GB. Ms. Ramlaul and her team recommended that radiographers and radiologists gain a better understanding of the intent of the document in order to become more confident when asking for consent.

Image of Radiographer signing papers — *Signed consent forms can be a way to build trust.*

Requesting a signed consent is even more sensitive when it is for a child. Parents and healthcare providers alike often see written consent as being needed “just in case” something bad happens, said J. Portelli. “Radiology risks are generally perceived to be much greater than they really are.”

A study by Ms. Portelli and her team on “Perceptions About the Practice of Seeking Informed Consent in Paediatric Imaging,” found that parents expressed feelings of heightened anxiety and concern when referring physicians and/or radiographers asked them to provide their written consent. Many interpreted it to mean that the imaging examination would involve higher risks for their child. Adding to the anxiety is the fact that the consent often is requested just prior to the procedure. This does not give parents time to read the consent form. And often, they are not given a copy of the form to review later.

Similarly, the healthcare providers in the study shared that they do not want to alarm patients by requesting signed consent. “This shows a lack of understanding about the true purpose of informed consent, which is to ensure that patients and/or their representatives are provided with relevant information that empowers their health decisions,” said the study.

Ms. Portelli and the team recommended that competent children and their parents/guardians should have adequate time to read information, ask questions and retain a copy of the consent form. The research team also recommended that the consent form be given at the time of referral, and again at pre-exam by the radiographer.

Patient information leaflets aid understanding

The Irish also had a perspective on sharing information in written form. M.L. Ryan of Dublin shared her team’s research on “Written Patient Information in Radiology.” The study found that 65 percent of the participating imaging facilities distributed Patient Information Leaflets (PILs). The most common information included in the PIL is the nature of the imaging procedure, the experience during the procedure, and result availability after the examination.

Like the consent form, Ryan recommends sharing the PIL in advance of the exam. This gives the patient time to digest the information and allows for time for discussion when they meet with the radiographer. Although some providers post the information online, the traditional paper handout remains useful to many patients.

“Putting the information in writing enhances the transfer of information to the patients. It also acts as a memory aid for patient and carers,” said Ms. Ryan.

Care for the radiographer and radiologist

Patients are not the only ones feeling stress and anxiety. Many radiographers and radiologists are struggling to maintain a work/life balance during a time of increased workload, staff shortages, and messaging apps and social media that can infiltrate their off hours.

Professor Mikael Boesen of the University of Copenhagen referenced a study showing that the number of CT and MRI images in the UK increased tenfold in a 10-year period. “Radiologists are now looking at an image every 3 to 4 seconds. We have gained increased specificity in the images, but that is not saving us time.”

The increase in the number of subspecialties adds to the stress level, said Claus Brix, director of professional policies at the Danish Council of Radiographers. “There are many growing demands on radiologists.”

Image of a human head made of paper and the top is on fire. — *Radiologists’ concerns include workload, shortages, and lack of opportunities.*

In the country of Malta, the concern is not only burnout, but also the lack of opportunities to progress in the profession due to the limited size of the country, according to the Society of Medial Radiographers of Malta.

And on the horizon is a patient population hungry to engage with radiologists and clinicians via social media, said Leslie Robinson in her talk on “Can Social Media Help to Involve Patients?”

But are radiologists ready for the added distraction of possible 24/7conversations via Facebook Messenger? Perhaps there is no area free of the digital influence after all.