How to Enhance Communication in Radiology Departments
The interdisciplinary nature of radiation oncology requires skilled communication to align care goals with patient preferences and to effectively manage the complex and emotionally nuanced medical information that patients receive about their disease trajectory. While formal integration of communication skills training in oncology residency has increased, further education and resources for practicing physicians remain scarce.
1. Set Expectations
Radiology departments can influence patient experience by being respectful, providing a calm environment, and encouraging patients to ask questions. All staff who interact with patients – including receptionists, healthcare assistants, nurses, and radiologists – should be trained to communicate effectively with a person-centred approach and manage patient records. Patients want to be listened to with empathy, informed of what is happening and why, and feel that they have been involved in their care. They also want to be able to ask questions, and to understand the results of their exam.
The current situation is that radiologists communicate most of their report findings to referring clinicians via written reports; however, the trend toward value-based and patient-centered care requires a greater emphasis on communicating directly with patients about non-routine findings. This will require radiologists to learn how to talk with patients about their test results in an effective way.
To do this, it is important for a radiology department to set the tone from the beginning. For example, the radiology team should consider introducing themselves to patients at the beginning of each interaction by telling them their names and job titles. This will give patients a sense of familiarity and trust, and may reduce their anxiety about the conversation.
It is also essential to teach radiology residents about health literacy and clear communication. This can be done through a comprehensive integrated curriculum, or in the form of episodic lessons over a shorter period of time. In addition, a variety of tools are available to assist with patient communications in radiology, such as structured reports, disease-specific templates, and interactive multimedia eLearning modules.
2. Practice One-on-One Conversations
As radiologists’ roles shift from mere scan interpreters to active members of the patient care team, effective communication is essential. This includes not only verbal communication with patients, but also written communication with referring providers and other healthcare staff. In the future, it is likely that this will include virtual meetings via telemedicine.
Aytekin Oto, MD, a neuroradiologist at the University of Chicago Medicine, believes that radiologists must be trained in how to communicate effectively. He explains that the best way to do this is by practicing one-on-one conversations with other physicians and trainees in the department, giving and receiving feedback and working together.
Another important component of communication is providing patients with clear information about their imaging examinations and procedures. This may include a written pamphlet-style document or video clips of the procedure itself. Studies have shown that providing this preprocedural education decreases patients’ anxiety and increases their satisfaction with radiology services (5).
It is also important for radiologists to clearly communicate the nature of non-routine findings, such as those that require immediate action or are discrepant from a preceding interpretation or those that could be potentially adverse to the patient’s health. Failure to do so can result in missed opportunities for improved patient outcomes (6).
Finally, it is vital to ensure that radiologists and their technologists understand the medical terminology used in reports from other disciplines, especially those outside of radiology. This can be a significant source of miscommunication as well, resulting in incorrect CPT codes for reimbursements or claim denials (7).
3. Encourage Feedback
Regardless of the age or experience level, every radiology professional should consider ways to improve communication skills. Often, the best way to do this is through a one-on-one conversation or through departmental meetings. As an example, a radiology manager at Community Hospital of the Monterey Peninsula developed a system to instantly receive patient feedback in the form of an online questionnaire. This system allows radiology staff to respond directly to patients’ requests and questions, resulting in a higher level of customer satisfaction.
Another approach involves establishing a multidisciplinary team to discuss issues that are impacting the radiology department culture. A team was formed that included the associate radiologist-in-chief of the department, a radiology quality improvement leader, and a radiology administrator. The team members were selected based on their mix of departmental subspecialties and personalities, as well as their willingness to actively participate in the discussion. The team met monthly and addressed several root causes of disrespectful behavior.
A key to success for this type of departmental initiative is creating a sense of ownership and responsibility within the team. To do this, the team members must feel comfortable addressing issues without fear of repercussions. In addition, the team members must feel that they can trust one another to share information about their professional performance, as well as their personal life.
To ensure that the radiology department is constantly improving its customer service, an ongoing system for obtaining and responding to patient feedback is also critical. Often, this involves incorporating an instant response form into the radiology appointment reminder emails to allow patients to ask questions and make special requests. This demonstrates that the radiology department is truly dedicated to its patients and their satisfaction. In addition, the system helps to prevent patients from feeling forgotten.
4. Encourage Interaction
As a highly integrated member of the patient care pathway, radiology must communicate effectively with patients and other healthcare professionals. This is not just about writing reports – radiologists must be available to answer questions about appropriate imaging modalities, understand the implications of their interpretations and explain complex medical terminology to referrers.
During interventional procedures, direct communication is necessary and important for obtaining patient consent and communicating life-changing findings to patients and families. This requires empathy, clarity and compassion in a difficult situation for patients who may not have a pre-existing relationship with the radiology team or have had bad news delivered to them.
Radiologists must also be available to answer queries about the appropriateness of different imaging modalities and questions/clarifications about their reports from referring clinicians, and they should be willing to discuss their findings with their referring colleagues face-to-face. They should also be able to provide a clear and transparent description of their role within the department, including the times when they are available.
It is also essential that radiologists remain accessible and can be contacted for advice about complex clinical cases such as vascular malformations or tumours. They should be able to respond to emails from referrers and arrange appointments when required. A dedicated contact point with a named radiologist and a telephone number should be established to enable referrers to make contact.
During routine interactions, frontline radiology staff such as technologists and reading room assistants need to feel valued and respected by their peers. Those who do not feel valued can be left feeling frustrated and deflated, which is not helpful to anyone, especially in a healthcare setting. For example, the lack of eye contact by a radiologist when asked a question can be misinterpreted as disrespectful and may lead to a patient safety incident or an unhappy referral. In addition, collecting the wrong patient data or inputting incorrect CPT codes can lead to billing delays and mistakes which can cause frustration for all parties involved.
5. Encourage Teamwork
Like any successful sports team, a radiology department thrives on a strong sense of community. That community extends beyond the walls of the hospital as well. A specialized group within the department, known as the Educators’ Committee, offers a chance for staff members to work together to advocate on behalf of their academic colleagues.
The committee is an open space where everyone can share their ideas and volunteer their talents toward initiatives. It has helped to improve the quality of education at the institution by fostering collaboration and allowing for more input from the academic staff.
A recent study highlighted that many healthcare professionals aren’t satisfied with their interprofessional communication. Ideally, patients should receive care from multiple health professionals – such as radiation oncologists, nurses, medical physicists and radiation therapists. However, poor interdisciplinary collaboration can lead to errors in patient treatment and less effective patient outcomes. This is especially true in developing countries, where healthcare professionals often have to deal with limited resources and a lack of infrastructure.
Improving teamwork in health care may help to decrease the number of errors, improve patient safety, and increase efficiency of treatment delivery. Health care professionals can better utilize available resources, provide a more comprehensive approach to patient care, and avoid service duplication through the use of clear communication and collaboration.
A way to encourage the development of these skills is by incorporating leadership training into medical residency programs. Cleveland Clinic’s radiation oncology program, for example, has added a day to their rotation where residents take a break from clinical duties to participate in experiential leadership exercises and listen to speakers on topics such as emotional intelligence.
