Paul Gene Thacker MD, Presenter: Nothing to Disclose

John Marshall Knudsen MD, Abstract Co-Author: Nothing to Disclose

Matthew A. Frick MD, Abstract Co-Author: Nothing to Disclose

Stacy R. Schultz BA, Abstract Co-Author: Nothing to Disclose

Sherrie L. Prescott RN, Abstract Co-Author: Nothing to Disclose

The duty to rapidly and directly report critical imaging results by the radiologist has been affirmed by the American College of Radiology, upheld by the courts, and codified by the Joint Commission (JC). The JC requires the collection and analysis of critical results communication and the development of effective strategies to improve timely communication. We evaluated our performance and identified the most common barriers to communication between the radiologist and responsible provider.

To assess compliance with critical results reporting, we retrospectively reviewed the reports of 3,706 chest CT studies performed to exclude pulmonary embolus (PE) between January 2008 and March 2009. Reports indicating evidence of acute PE were audited for direct communication within 1 hour of exam completion and documentation of the provider’s name and time. A survey was then sent to all radiologists in the department to determine the barriers to communication.

308 of 3,706 (8.3%) reports indicated presence of acute PE. Direct communication occurred within 1 hour of image acquisition in 86% of cases. Survey respondents (N=135) indicated that initial attempts were often unsuccessful with eventual communication often requiring a time intensive effort. The two most commonly stated barriers to efficient communication was unavailability of the ordering physician (40%) and unwillingness to take responsibility for the patient (24%). Other less common barriers to communication were when the ordering physician was not the actual care provider (18%) or lack of accurate contact information (7%).

While the issue of critical results reporting has received some attention in the radiologic literature, we are aware of no systematic review of the barriers to direct communication. Our results show that although attempts to report critical results to the appropriate care provider are eventually successful, barriers must be addressed to optimize effective and efficient communication. We have instituted changes to our ordering system, encouraged the use of an existing lab results call center and updated our reporting format to improve critical results communication.

Radiologists have a duty to audit critical results reporting rates and develop strategies for improving effective and efficient direct communication.

Thacker, P, Knudsen, J, Frick, M, Schultz, S, Prescott, S, Barriers to Effective Communication of Critical Imaging Results.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012349.html