Help or put on hold: when do you keep your colleagues waiting?

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Survey results show that the radiologist’s availability to clinical colleagues is an important part of the imaging service. So how do you balance that availability and your regular workflow? We want to hear your thoughts below.

In 2011, Lindsay et al. published the results of a survey aimed at assessing what factors affected satisfaction with radiology services amongst referring clinicians (1). The survey was conducted shortly after implementation of a PACS system across three hospitals, and focused mainly on the changes created by improved communication between radiology and other hospital departments. Overall, respondents had a positive opinion of the impact of PACS installation, with the majority feeling it decreased the reporting times and ameliorated the working pattern for medical staff. Furthermore, there were a number of indicators showing that direct access to the radiological images did not decrease the importance of the radiology reports. On the contrary, the higher the experience of the referring clinicians, the higher the perceived value of this part of the radiologists’ work.
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‘Image factories’ or ‘clinical imaging services’: what does the future hold for radiology departments?

A recent article in the New England Journal of Medicine raises some very interesting questions about the future of imaging service provision. Who are we as radiologists, and where do we want to go? Are we running “imaging factories” or “clinical imaging services”? We would like to hear what you think in the comments section at the bottom of this article.

Are modern radiologists just cogs in an image production machine?

Dr. Saurabh Jha is a radiologist working in the Department of Radiology at the Hospital of the University of Pennsylvania, Philadelphia. Before that, he had a professional life as a surgical trainee on this side of the pond, in England. In a paper entitled From imaging gatekeeper to service provider – a transatlantic journey
(N Engl J Med 2013:369:5-7) he underlines the differences between the way he perceived radiologists when he worked in Europe as a surgeon and the way he practices radiology in the USA. English radiologists were gatekeepers: that is, they provided imaging studies only when they were really appropriate and necessary according to their clinical judgement. American radiologists are service providers; that is they perform and read the examinations requested according to the referring physicians’s clinical judgement.

“Evaluation of radiological services in the USA is based on the volume of examinations and turnaround time; the higher the number of studies, the better it is for the department.”

Dr. Jha explains that this difference is mostly related to the fact that imaging was a scarce commodity when he was working for the British National Health Service while, on the contrary, there is abundance of CT scanners, MRI machines, and technologists in the United States. Another explanation is that evaluation of radiological services in the USA is based on the volume of examinations and turnaround time. In such a case, the higher the number of studies, the better it is for the department.
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TMC Radiology Quality Award offering €10,000 prize for second time at ECR 2015

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The winners of the TMC Radiology Quality Award 2014 from the Silkeborg Clinic (Denmark) with members of the jury at ECR 2014. Left to right: Lluís Donoso Bach (jury), Annette Meyer Balle, Jarl Jakobsen (jury), Rikke Aarhus, Peter Mildenberger (jury), Agnete Hedemann Nielsen, Hans Billing (jury), Susanne Skovlund Petersen, Ian McCall (jury)

The European Congress of Radiology always includes many presentations, but not many of them involve a cheque for €10,000. Last year, at ECR 2014, that was exactly what was presented to Agnete Hedemann Nielsen, Annette Meyer Balle, Susanne Skovlund Petersen and Rikke Aarhus of the Silkeborg Clinic in Denmark, winners of the inaugural TMC Radiology Quality Award.

The award, which is still open for submissions this year until December 31, is open to professional individuals or groups working in European radiology departments and is given by Telemedicine Clinic, the leading European provider of teleradiology services, to promote radiology-related quality initiatives in Europe.
With such a substantial prize on offer, last year’s award attracted some remarkable entries, but the one from Silkeborg most impressed the international jury. The Danish team introduced a process to improve the quality of diagnosis of minor stroke within their hospital, which was previously meeting national standards in 70% of cases. The systems they implemented had an immediate impact, raising that figure to 90% within two weeks and ultimately leading to reduced length of stay, reduced time of diagnosis, faster initiation of treatment, and improved diagnostic accuracy. You can read more about the winning project, as well as the second and third placed entries, here.

So, if you have been involved in a project that has had a positive impact on radiological quality, check out the submission categories and put in for the award. You have nothing to lose, but a possible €10,000 to gain!

Caceres’ Corner Case 72 (Update: Solution)

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Dear friends,

Showing post-operative radiographs of a 34-year-old male. Muppet saw the films without clinical information and was completely lost.

Can you interpret the findings and shame Muppet into early retirement? Check out the images below, post your thoughts and possible diagnoses in the comments section, and come back next Tuesday for the answer!

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Jun 2013
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