Lecture 10: Avoiding communication failures
Goal: Understand how to avoid communication failures that can result in delays in diagnosis and treatment
Objectives
- Describe scenarios where communication failures occur involving radiologists
- Discuss the importance of closed-loop communication for unexpected findings
Recommended reading
Lecture 10 Pretest
Which of the following is a solution to address incorrect or inadequate clinical history provided in imaging requests?
- A hard stop in the ordering process requiring providers to enter a clinical question
- IT mechanisms that link PACS and EMR to obtain pertinent history from medical records
- Financial rewards for ordering providers to enter more clinical information in imaging requests
- 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?
- Contradictory statements within the final report
- Typographical errors
- Missense errors such as omitted words
- 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?
- Document the discrepancy in the final report
- Call the ER but don’t document the discrepancy in the final report to protect the resident
- Call the ER and document communication of the sternal fracture in the final report
- 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?
- Incidental 3.4 cm pancreatic cystic lesion
- Gallstones in a decompressed gallbladder
- Healed rib fractures
- 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?
- Lab values (e.g. white count and liver function tests)
- Tumor markers
- Prior surgeries
- Localizing signs and symptom
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