Costly Radiology Callbacks Erode Patient Trust: How To Reduce Them?

Imaging
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Imaging "callbacks" refer to instances when patients are asked to undergo a repeat or additional radiologic examination. While such callbacks may be uncommon, these are inconvenient for patients and can erode their trust in radiologists, according to researchers with the Department of Radiology at Michigan Medicine.

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These callbacks are said to be radiology’s equivalent to wrong-site errors in surgery, and as much as possible must be prevented to avoid healthcare waste and unnecessary expenses, the researchers noted in their study published in the American Journal of Roentgenology.

“Callbacks frustrate patients and erode trust between radiologists, patients, families and referring providers,” explained study co-author Amber Liles, MD, a radiology resident with Michigan Medicine. “Calling back patients for additional imaging because of insufficient or inappropriate imaging reflects poorly on our specialty.”

Dr Liles and colleagues reviewed 147,068 MRI and 195,578 CT examinations performed in four subspecialties (cardiothoracic, abdominal and musculoskeletal imaging and neuroradiology) at an academic medical centre. They found that there were only 194 callbacks among those thousands of tests conducted between October 2015 - October 2017. In addition, callbacks occurred more often for MRI than CT.

Based on this study, the four leading causes of callbacks are:

  • Protocol errors accounted for 28% of callbacks, with nearly half attributed to a resident or fellow and the other half linked to attending radiologists.
  • Inadequate anatomic coverage was the cause of about 21% of callbacks, with 50% occurring before the test (due to inadequate patient history or a radiologist error) and the other half occurring at the time of the examination. 
  • Incomplete examinations led to about 13% of callbacks, including wrong plane of imaging or the missing use of contrast agents.
  • Perceived suboptimal image quality triggered 11% of callbacks, including poor signal-to-noise ratio, inadequate fat saturation, and artefact from lack of metal suppression. The top three causes of callbacks are all largely preventable, the researchers noted, adding that targeted improvement efforts can help mitigate the problem.

“Improving communication (ie, referrer to radiologist to technologist), creating systems to make needed detail transparent, and ensuring correct information before an examination appointment are all domains to explore for optimisation,” Dr Liles pointed out.

Source: Radiology Business; American Journal of Roentgenology
Image credit: iStock

Reference Liles AL et al. (2019) Common Causes of Outpatient CT and MRI Callback Examinations: Opportunities for Improvement. Am J Roentgenol: 1-6. 10.2214/AJR.19.21839.

Published on : Mon, 6 Jan 2020



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