Klobuka Andrew J, Lee John, Buranosky Raquel, Heller Matthew
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Drexel University College of Medicine, Pittsburgh, PA.
Curr Probl Diagn Radiol. 2019 Jul-Aug;48(4):312-322. doi: 10.1067/j.cpradiol.2018.02.005. Epub 2018 Feb 13.
Current radiology and internal medicine (IM) residents have trained to varying degrees depending on program in the post picture archiving and communication systems implementation era and thus have largely missed out on the benefits of in-person, 2-way communication between radiologists and consulting clinicians. The purpose of this study is to broadly explore resident perspectives from these groups on the desire for personal contact between radiologists and referring physicians and the effect of improved contact on clinical practice.
A radiology rounds was implemented in which radiology residents travel to the IM teaching service teams to discuss their inpatients and review ordered imaging biweekly. Surveys were given to both cohorts following 9 months of implementation.
A total of 23/49 diagnostic radiology (DR) and 72/197 IM residents responded. In all, 83% of DR and 96% of IM residents desired more personal contact between radiologists and clinicians. Of all, 92% of DR residents agree that contact with referring clinicians changes their approach to a study, 96% of IM residents agree that personal contact with a radiologist has changed patient management in a way that they otherwise would not have done having simply read a report, 85% of DR residents report that more clinician contact will improve resource use, and 96% report that it will improve care quality. Furthermore, 99% of IM residents report that increased access to a radiologist would make selecting the most appropriate imaging study easier in various clinical scenarios. A majority of IM residents prefer radiology reports that provide specific next-step recommendations and that include arrows/key-image series.
We conclude that the newest generation of physicians is already attuned to the value of a radiologist who plays an active, in-person role in the clinical decision-making process.
在图像存档与通信系统实施后的时代，当前的放射科和内科住院医师培训程度因项目而异，因此在很大程度上错过了放射科医生与咨询临床医生面对面双向交流的益处。本研究的目的是广泛探讨这些群体中住院医师对于放射科医生与转诊医生进行个人接触的意愿，以及改善接触对临床实践的影响。
开展了放射科查房，放射科住院医师前往内科教学服务团队，每两周讨论他们的住院患者并复查已开具的影像检查。实施9个月后，对两组人员进行了调查。
共有23/49名诊断放射科（DR）住院医师和72/197名内科住院医师做出了回应。总体而言，83%的DR住院医师和96%的内科住院医师希望放射科医生与临床医生之间有更多的个人接触。其中，92%的DR住院医师同意与转诊临床医生的接触改变了他们进行研究的方法，96%的内科住院医师同意与放射科医生的个人接触改变了患者管理方式，否则他们仅仅阅读报告是不会这样做的，85%的DR住院医师报告说与临床医生更多的接触将改善资源利用，96%的人报告说这将提高护理质量。此外，99%的内科住院医师报告说，在各种临床情况下，增加与放射科医生的接触将使选择最合适的影像检查更容易。大多数内科住院医师更喜欢提供具体下一步建议并包括箭头/关键影像系列的放射科报告。
我们得出结论，最新一代的医生已经认识到放射科医生在临床决策过程中发挥积极的面对面作用的价值。
