Improving Patient Care through Effective Communications with Radiology
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Insights from radiologists, radiographers and patients at ECR 2022.
Table of contents
- The Role of effective communications in improving patient care in radiology
- Recommendations for communicating effectively in radiology
- Barriers to communicating effectively with patients
- Resources for improving patient communications in radiology
Communicating clearly and thoughtfully with patients can help improve patient care – and there is a need for considerable improvement in radiology.
That message was delivered repeatedly in several presentations given by radiologists, radiographers, and patients at the European Congress of Radiology (ECR) in July. Presentations on the topic were part of a series of sessions on “Patients in Focus” managed by the ESR Patient Advisory Group. (1)
“Never refuse a dialogue with a patient in any circumstance: before, during, and obviously after the exam,” stressed Dr. Dominique Carrié, Clinical Radiologist, France, ESR-PAG, French Society of Radiology, CERF. “Come out of the darkroom; your presence is important.”
The role of effective communications in improving patient care in radiology
Following are significant benefits that can be gained by communicating effectively, and taking the time to communicate, according to presenters:
- Gain the trust and confidence of patients to gain their compliance to perform an exam
- Provide better patient care
- Provide better patient experience
- Provide better outcomes
- Increase patient safety
- Improve patient satisfaction
- Help avoid potential medico-legal conflicts
- Reduce safety errors
The potential benefits are strong; yet communications are often lacking, according to results from a patient survey (2) conducted by the European Society of Radiology (ESR). Responses were received from 400 patients from 22 countries in the EU. Thirty-six percent of respondents reported that they were not satisfied with the information provided about the risks and benefits of procedures, and thirty-three percent reported not being satisfied with the availability of radiologists for consultation, potentially suggesting that some patients lack sufficient information to participate fully in treatment decisions. One conclusion of the study was that “simple measures could have a significant impact in improving communication and patient satisfaction.” (2)
“We are the experts patients look up to for information, advice and reassurance. We need to make our time with the patient count,” emphasized Dr. Jonathan L. Portelli, PhD, L-Universita ta Malta.
Recommendations for communicating effectively in radiology
Presenters agreed that it takes practice and perhaps training to become an effective educator. Following is a summary of tips specific to radiology from presenters at ECR for communicating effectively with patients.
Pre-exam
- Introduce yourself and your role
- Explain what is to be done, expected, felt, and/or heard
- Highlight the exam benefit while also indicating the smaller associated radiation risk
- If there are communications on display – such as posters – that have helpful patient information, point them out.
Don’t assume that the patient read them. - Ask patients, “what do you want to know?”
- Give clear answers about radiation risks
- Limit your conversation to what you know
Cheryl Cruwys, founder of Breast Density Matters UK and a patient representative on the editorial board of ecancer.org, emphasized the important of providing information in advance of exams to give patients enough time to read and digest the information. Additionally she recommended that communications be available in different forms, like videos, and in different languages.
Post-exam: sharing results
The following recommendations were delivered by Dr. Carrié.
When sharing the results of a diagnostic exam, do so in a confidential place and with the capability to show and share the radiographic images. The “place” can be in a physical office or teleconference.
Begin by introducing yourself and your role. Speak about your knowledge and experience. If people other than the patient are in the meeting, ask for their relationship to the patient. In the case of a virtual conference, clarify who is speaking – the patient or a representative.
Present the information, paying attention to their body language and other cues about their understanding. Adapt your answers as needed so that they are understood.
When the results are serious, deliver them with empathy. The information will be received better by the patient when empathy is provided. Pause after delivering the news to give the patient time to react.
In all situations, ask for questions, listening carefully to understand what is being asked.
At the conclusion, open the door for further support such as additional imaging or tests, especially if the pathology is serious. Offer the names of a specialist or specific hospital if surgery is required.
“Throughout the communication, watch to see if you are being understood and give people a chance to ask questions,” urged Jonathan McNulty, Associate Professor and Vice Principal for T&L, College of Health and Agricultural Sciences; Associate Dean, School of Medicine University College Dublin. “Remember that communications is a two-way transaction between both parties.”
Barriers to communicating effectively with patients
The presenters made a strong case on the value of communications for improving patient care in radiology. Still there are obstacles. One is a lack of training for radiologists and radiographers on communication skills . According to a study by ESR, 63.7% of radiologists rarely or never receive training on communication.
A second challenge is that some referring doctors do not want radiologists to deliver results, preferring to deliver the information themselves. Patients who presented at ESR challenged this idea, stating that they have the right to hear the results as soon as they are available.
Third, some radiologists are concerned about the time involved if they open the door to having patient conversations. However, Dr. Carrié said that only about 5 to 10 percent of patients ask to have a conversation – a manageable amount. Lastly, some radiologists simply don’t want to have the conversations, said Dr. Carrié who recommended – in the case of radiologists on call – designating one radiologist each week to take calls.
Taking your own initiative to improve your communication skills was a strong call to action for radiologists and radiographers given throughout the Patients in Focus series. Although the benefits to patients are the most important, improving your communications skills will also help you with your communications with colleagues, and improve team dynamics. Additionally, interacting with patients “will give you a new sense of pride to work as a radiologist,” said Dr. Carrié.
“Communications is a skill,” said Professor McNulty. “You won’t always be a perfect communicator, but you can always try harder. We have limited time with patients. it’s important to make the most out of it.”
Resources for improving patient communications in radiology
Patient Centred Care in Diagnostic Radiography: An Educational Toolkit from the University of Derby
Poster: Always Consider the Needs of Your Patients, from the European Society of Radiology
Katie Kilfoyle Remis is the editor of Everything Rad; and the Digital Media and Public Relations Manager for Carestream Health. Contact her with blog ideas at Katie.Remis@carestream.com
