PC 15a - Radiology at the core of interdisciplinary communication
1. To appreciate the importance of communicating in a timely and clear way.
2. To understand the particular issues related to communicating verbally or using written or electronic information.
3. To appreciate how the communication style and needs will be different for different groups of people.
The role of a radiologist is the same as any other doctor - to help patients. In diagnostic radiology, this is often done through written communication (report) to the referrer. The radiologist should understand the needs of the referrer and ensure that the radiological findings are clearly described and interpreted in the light of the clinical information. It should also be communicated in a timely manner to prevent patient harm. The means of communication should be secure and ensure that patient data are processed in line with data protection legislation.The challenges to effective communication can be significant, even when the radiologist and referrer are in the same institution, but are potentially magnified with offsite teleradiology. Direct verbal discussion in clinico-radiological meetings can add considerable value, and discussion directly with patients is recognised to be important for the future of radiology, but is increasingly 'squeezed out' by the volume of work.
1. To identify who you will be communicating with within the hospital and who will be communicating with you.
2. To learn how to avoid miscommunication or misunderstanding.
3. To learn how to promote effective communication.
Communication within hospital walls is a difficult process due to the multiple interconnections between individuals having different professional profiles. Furthermore, sharing information implies knowledge of management of sensitive information, including patient medical records. In this lecture, both the behavioural and technological aspects of knowledge sharing within the hospital will be explored, and tips will be provided to avoid miscommunication or misunderstanding. Effective communication through information sharing of electronic health records and the role of multidisciplinary team meetings on patient assessment, management and outcome will be reviewed.
1. To identify the key routes of communication outside the hospital, including teleradiology.
2. To understand barriers to good communication.
3. To learn how to promote good communication.
Communication between radiologists and referring physicians depends mainly on 4 columns: referral forms, radiology reports, individual consultations and clinical conferences. If radiologists and referring physicians are familiar with each other, communication is usually easy and efficient. Years of collaboration and "problem solving" generate a positive working environment supporting a trustworthy communication between equal partners. This positive attitude between radiologists and clinical partners supports a concise and team-oriented communication. Thus, the most important clinical information (previous/chronic illnesses, current complaints; risk factors for adverse events related to the planned procedure) is usually included in the referral forms. If this is not the case, direct consultation of the referring physician or of the electronic patient record is possible in an in-house setting. The same applies to questions regarding the indication for an radiological exam/procedure and the choice of exam/procedure. Communication beyond the hospital is sometimes hampered because of technical reasons and misunderstanding due to lack of appropriate information and a lack of knowledge regarding the requested radiological exam/procedure. Typical technical obstacles to efficient communication are lacking clinical information, ill-defined indications for exam/procedure and non-availability of the person you want to talk to in case of missing information. Triage of patients in case of workforce overload is another problem which cannot be easily dealt in case of an outside referral. Typical examples will be given which illustrate the above-mentioned scenarios. In addition, solutions how to avoid bad communication will be given.
1. To understand what information patients require before they attend a radiology department.
2. To appreciate the communication needs of patients when they are undergoing investigations, and when they receive results.
3. To learn how to communicate effectively with patients.
The average patient is a statistical invention and does not attend the radiology department. Even the equipment used has a set of possibilities to adjust to the individual size of a patient. The same is true with the communication capabilities of the patients. This is caused by the differences is coping capacity and literacy. The information that a patient needs or wishes when he enters the radiology department is at different levels. The internal level of the department is really linked to what is done in the department, how it is done, etcetera. This should be known by the patient and can be provided on paper or any other means that are effective. But, as patients are so diverse this information should also be offered in a multi-layered system, and the radiologist should be available to answer questions or have someone available who can. The other level is the pathology, the reason why the patient is coming to the department. This can be quite simple a broken rib or wrist, questions on this can be answered in the department as the clinical data are rather clear. But complex pathologies require knowledge of the patient file, his past, family situation and more, only known by the clinician who did the referral. In these cases, the best option is the interdisciplinary consult with the clinician where the radiologist can transmit his feelings about the patient and findings. In these cases, the clinician would be the ideal person to speak with the patient.