Lecture 10: Avoiding communication failures
Goal: Understand how to avoid communication failures that can result in delays in diagnosis and treatment
Objectives
Recommended reading
Lecture 10 Pretest

Which of the following is a solution to address incorrect or inadequate clinical history provided in imaging requests?

  1. A hard stop in the ordering process requiring providers to enter a clinical question
  2. IT mechanisms that link PACS and EMR to obtain pertinent history from medical records
  3. Financial rewards for ordering providers to enter more clinical information in imaging requests
  4. Implementation of clinical decision support to ensure accurate clinical histories in imaging orders

Which of the following is a common error that occurs as a result of using pre-populated report templates?

  1. Contradictory statements within the final report
  2. Typographical errors
  3. Missense errors such as omitted words
  4. Voice recognition errors

What should a radiologist do when he identifies a missed sternal fracture on a chest CT interpreted by a resident overnight, and the patient has already been discharged?

  1. Document the discrepancy in the final report
  2. Call the ER but don’t document the discrepancy in the final report to protect the resident
  3. Call the ER and document communication of the sternal fracture in the final report
  4. Send the case to the residency program director

For which of the following scenarios does the ACR practice parameter for communication suggest that non-routine communication may be warranted?

  1. Incidental 3.4 cm pancreatic cystic lesion
  2. Gallstones in a decompressed gallbladder
  3. Healed rib fractures
  4. Adrenal nodule measuring less than 10 Houndsfield units on unenhanced CT

In the setting of trauma, what relevant information in the EMR can significantly impact diagnostic errors?

  1. Lab values (e.g. white count and liver function tests)
  2. Tumor markers
  3. Prior surgeries
  4.  Localizing signs and symptom
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