A GUIDE TO VALUES-BASED PRACTICE IN RADIOGRAPHY
Reading Time: 7 minutes read
A radiography educator explains how to utilise VBP in daily practice
By Dr. Ruth Strudwick, Associate Professor and Subject Lead for Radiography and Interprofessional Learning at The University of Suffolk.
Values-Based Practice (VBP) is the consideration of a patient’s values in decision-making. By patient’s values, we mean the unique preferences, concerns and expectations each patient brings to a practice encounter, including radiography. These unique values must be integrated into any decisions about the care of the patient. In essence, VBP takes into account and highlights what matters, and therefore is important, to the patient (1).
Values-based practice supports Standards of Proficiency for Radiographers
All health care professionals have standards of proficiency. The Standards of Proficiency for Radiographers (2) (Statements 2, 5 and 8) clearly tell us that we must:
- Understand the need to respect and uphold the rights, dignity, values, and autonomy of service users including their role in the diagnostic and therapeutic process and in maintaining health and wellbeing (2.3).
- Understand the requirement to adapt practice to meet the needs of different groups and individuals (5.1).
- Understand the need to provide service users or people acting on their behalf with the information necessary to enable them to make informed decisions (8.5).
Radiographers can do all of this by giving the patient the opportunity to explain what is important to them; and by providing the patient with enough information so that they can make an informed choice. This is a critical aspect of truly patient-centred care and VBP.
It is very easy to ‘pigeon hole’ patients and only consider the area of the body to be imaged, e.g. “the next patient is a foot”, or “there is a chest waiting”. VBP reminds us that different people have differing values. In addition, one person’s values may vary from one encounter to another, depending on the situation and how they are feeling on that given day. Also, patients may value very different things from various practitioners. Therefore, it is important not to make assumptions about how a patient is feeling or what might be important to them. Each patient must be considered as an individual.
Utilising VBP in radiography practice
How can radiographers utilise VBP in practice? The most obvious step is to get to know the patient and ask what is important to them. In addition, no decisions should be made about the patient without their involvement. ‘No decision about me without me’ (3).
For example, in diagnostic imaging the radiographer and patient can discuss how best to achieve the required images, and if any adaptation in technique is required. By explaining to the patient what is required, co-operation is much more likely with a good outcome for everyone involved. This might be allowing the patient to sit instead of stand, or sit instead of lie down. Other examples might be negotiating a suitable time for an appointment that suits the patient, or consideration of the best location for a patient to change into a gown. These are all simple examples, but give due consideration to what is important to the patient.
Findings on patient values
I am currently doing research with a colleague to understand what patients, radiographers and managers value in X-ray examinations. Some of the initial findings from the patients indicate that they value very small things that are easy to achieve. The patients say they appreciate:
- Staff smiling and introducing themselves properly, #hellomynameis (4),
- Maintaining eye contact
- Giving them time
- Engaging them in conversation
- Explaining what is about to happen
- Giving them a chance to ask questions
- Involving them in the decision-making process.
All of these are simple, yet effective, ways of valuing the service user and incorporating VBP in Radiography. These actions do not take much effort and will probably save time in the end, as the patient will be more involved and have a better understanding of what is required.
When embedded, VBP will provide assurance that radiographers put the patient at the centre of everything we do (5).
A guide to Values-Based Practice in Diagnostic and Therapeutic Radiography
A small team made up of the committee members of the Association of Radiography Educators (ARE) and other interested radiography educators adapted materials from a VBP handbook originally developed for medicine. The handbook, conceived by Professor Bill Fulford and Dr. Ashok Handa (6), has been customised by the team for use by diagnostic and therapeutic radiographers. Our handbook, Values-based Practice in Diagnostic & Therapeutic Radiography, introduces the concept of a VBP that complements evidence-based practice to ensure a holistic service. The handbook, which was designed by and for radiographers, is intended to raise awareness for VPB. The scenarios included in the text have been piloted with radiographers and undergraduates at study days and in teaching sessions. We are grateful to the participants for their input.
At the end of any training session we ask radiographers, are you:
An enthusiast of VBP and eager to take things forward?
A sceptic dubious of the practicality of VBP in the face of ‘cuts’ and other threats to services?
We also ask them to come up with one small change (a ‘tweak’) that they can realistically make in their own practice. So now I ask you, what will you do as a result of reading this?
Dr. Ruth Strudwick is an Associate Professor and Subject Lead for Radiography and Interprofessional Learning at The University of Suffolk. She is also the chair of the Association of Radiography Educators, the Editor of the Journal ‘Imaging and Oncology’, an accredited assessor for the Society and College of Radiographers, Chair and Committee member of the College of Radiographer’s Research Group, an External Examiner for University College, Dublin and The University of Derby, Chair of the East Anglia Regional CAHPR Hub, and reviewer for five international journals.
- Fulford K.W.M, Peile E and Carroll H (2012) Essentials of Values-based Practice: Clinical Stories Linking Science with people. Cambridge University Press, Cambridge
- HCPC (2013) Standards of Proficiency for Radiographers. HCPC, London
- DH (2012) Liberating the NHS: No decision about me without me. DH, London.
- Granger K (2013) https://www.hellomynameis.org.uk/ accessed 12/04/2019.
- The Association of Radiography Educators, The College of Radiographers and The Collaborating Centre for Values-based Practice in Health and Social Care (2018). Values-based Practice in Diagnostic and Therapeutic Radiography: A Training Template [online] [Date accessed]. Available from: https://www.sor.org/sites/default/files/document-versions/2018.10.03_radiography_vbp_training_manual_-_final.pdf
- Fulford K.W.M and Handa A (2011) Values Based Practice In Clinical Care – A Training Template. The Collaborating Centre for Values-Based Practice in Health and Social Care, Oxford