Best Practices for Radiologists’ Clinical Integration

Clinical integration through established means of direct contact, interdisciplinary rounds, and conferences are highly regarded metrics of quality by clinicians, according to a study presented at RSNA 2016.

Researchers from California performed a survey to better conceptualize quality in both reporting and clinical radiology through the perspective of the clinician. They sent out a 40-question survey to residents, fellows, and attendings at an academic, tertiary-care institution, asking about preferences regarding report formatting, time utilization, and clinical involvement of radiologists.  The answers ranged from 1, meaning “strongly disagree” or “never,” to 5, meaning “strongly agree” or “always.” Responses were received from 80 attendings, 12 fellows, and 46 residents, for a total of 138 responses.

The results showed the respondents were strongly in favor of quality through integration into the health care team with formal consultation, interdisciplinary rounds, and conferences. Clinicians favored direct communication regarding critical findings. Although respondents tended to neither agree nor disagree with increased patient interaction with radiology, a small proportion disagreed with direct discussion between the patient and the radiologist and direct referral for interventional services.

When asked about reporting, providing key images with measurements and key findings was viewed favorably, while allowing flexibility in time constraints for literature references was not favored. Statistical analysis demonstrated that direct referral for further diagnostic testing from radiologists was significantly more favorable with residents as compared to fellows or attendings. Integration into the health care team was viewed more favorably by fellows and attendings when compared to residents. Detailed discussion of the findings and differential diagnoses was also view more favorably by attendings as compared to residents.

The researchers concluded that clinical integration through established means of direct contact, interdisciplinary rounds, and conferences were highly regarded metrics of quality by clinicians, but also, direct patient contact can be disagreeable with a minority of clinicians.