Radiology’s Role in the Patient Experience
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Brigham and Women’s Hospital’s initiative to measure the patient experience in radiology.
Editor’s Note: Today’s blog is one of a series about the patient experience in radiology. Earlier we shared 2 blogs by Dr. Cheryl Turner on root causes of adverse patient experiences in radiology. Be sure to check back on June 30 when we publish an interview with ABC Hospital on the role of mobile imaging in patient care.
Why the patient experience in radiology matters
Recently, there is growing awareness that engagement with radiologists can help increase patient trust and satisfaction, leading to calls for radiologists “to come out of the dark” and engage with patients. (1)
Studies show that improving a patient’s experience can provide important benefits to both the healthcare provider and the patient, including:
- Decreased complaints and malpractice claims.
- Improved patients’ physical and mental health.
In fact, a study published by the Journal of the American College of Radiology found that 78 percent of respondents found patient interaction to be a satisfying experience; and 54 percent of radiologists desired more opportunities for patient interaction. (2)
Going forward, it might also impact the bottom line. Today, many online-savvy patients research imaging and other healthcare facilities before choosing a provider. Did you know that “patient experience” is now a factor in U.S. News & World Report rankings? Also, the Center for Medicare and Medicaid Services (CMS) surveys hospitals (with HCAHPS (3)) and uses those results as part of its Hospital Value-Based Purchasing Program.
Measuring the patient experience in radiology
For all these reasons, Brigham and Women’s Hospital (BWH) started an institutional Patient Experience Initiative that includes our Department of Radiology. Two of the primary objectives for our initiative are:
- Improve patient experience in radiology through the use of robust data collection and analysis.
- Improve survey results for diagnostic imaging and interventional procedures.
In the past, we captured patient feedback by mailing paper surveys to a small sample of patients. The results were sent to the site manager without any additional oversight. In a typical year, we received 2,000 responses.
With our new initiative, we received 26,210 responses in a 12-month period (May 2017 to April 2018). Our process was managed by an outside consulting service with knowledge of patient experience surveys in radiology. All outpatients were emailed a survey 2 days after their visit; with a reminder email sent 5 days after the initial survey. Our response rate was 20.2 percent.
Some of the survey questions relate to the facility, asking patients to rate elements like ease of parking and cleanliness of bathrooms. However, the Procedure Survey has 10 questions that ask patients to rate their radiologist. This includes any patient-facing radiologist who performs a procedure including abdominal, thoracic, musculoskeletal, and breast imaging. The survey uses the 5-point Likert Scale (Very Poor to Very Good). Each section also has a free text comment box.
Rating the radiologists
Patients are asked to rate their radiologist on these 10 areas:
- Friendliness and courtesy
- Explanation of problem/condition
- Concern for questions/worries
- Efforts to include in decisions
- Information about medications
- Instructions for follow up care
- Use of clear language
- Time spent with patient
- Confidence in caring physician
- Likelihood of recommending
We were pleased that the overall rating for radiologists was 4.8 out of 5. Also, the scores for each of the 10 questions for radiologists were not significantly different than non-radiologists’ scores.
Improving the patient experience in radiology
Of course, there is always room for improvement. Based on the surveys, we were able to identify numerous small changes that have improved patient satisfaction. The changes include improving comfort and cleanliness of waiting rooms, employee education about service expectations, and increased access to a variety of patient gown sizes. Over the course of one year, our department’s scores improved on many of the questions, and we expect that further training and education may lead to additional improvement.
To help keep patient experience top of mind, our radiologists and radiologic technologists have access to additional badges that label their role, and list the survey questions applicable to their role. These badges are worn on a lanyard in additional to their regular hospital badges. One side lists the survey questions. The other side has the corresponding action to meet patient expectations.
Public ratings of radiologists
Many physicians are initially uncomfortable with having their care rated by their patients and having those results published online for the world to see.
However, this is already happening. More than 40% of the U.S. public seeks online information about their healthcare providers. Physician ratings are already on various online platforms including Rate MDs, vitals.com, and yes, even Yelp. Have you looked yourself up on these platforms recently? You might be surprised to see how many physician reviews are already online.
That’s why we confidentially provide patient survey comments through our online platform, where we have a well-defined process for oversight and comment screening. All comments are reviewed by a multi-disciplinary group, and there are well-defined criteria for deciding whether a comment should be made public. No patient identifying information is included in the comments. Also, providers have the opportunity to review and dispute a comment before it is made public. Making the comments public improves transparency and helps other patients who are searching for patient-facing radiologists.
At BWH, we believe that patient comments provide a wealth of knowledge for specific interventions that can improve the patient experience. But patient feedback needs to be part of a larger initiative; and the process of eliciting comments needs to be organized.
Neena Kapoor is the Quality and Safety Officer, Department of Radiology; Brigham and Women’s Hospital; Assistant Professor, Harvard Medical School. She delivered a presentation of the hospital’s Patient Experience Initiative at RSNA 2019. Read more results from the study in the article in the American Journal of Roentgenology.
Read more about radiology’s role in the patient experience:
- Patient Safety Issues in Radiology: Part One
- Patient Safety Issues in Radiology: Part Two
- A Guide to Values-Based Practice in Radiology
- Building Trust in the Radiologist Patient Relationship
- Streamlining image capture workflow frees up rad techs to spend more time with patients
- Strategies to Increase Patient Satisfaction Scores