Integrate the Human Factor in Your Work
The profession of radiology has been progressing over the past fifty years in terms of how people are trained, equipment and technology used, and immediacy of feedback. Yet despite these advances, error rates often remain statistically significant and frustratingly high depending on the type of reading performed – bone density, chest radiographs, mammograms, gastrointestinal, and beyond. According to Imaging Economics, the reading error rate can vary from 2% to as high as 20%, depending on the scan, the clinician, the environment, and even the time of day. And up to eighty percent of the errors are perceptual errors. That is, the information was present and shown on the film or scan, but not identified and seen by the radiologist.
Yehonatan Turner, M.D., was a radiology resident at Shaare Zedek Medical Center in Jerusalem in 2008 when he decided to experiment with humanizing the process of reading radiology scans, to learn what affect it might have on the quality of the reading and the error rate of the clinicians. He and his colleagues performed an experiment in which they asked 267 patients for their permission to be photographed before their CT scans. A Computed Tomography scan is a more detailed X-Ray exam that focuses on a specific part of the body and yields a more detailed image of what’s inside the body.
Those 267 patient photos were submitted within a total of 1,137 CT examinations and would automatically be presented to the radiologist when evaluating the scan. Seventeen radiologists performed the readings and the results were quite surprising:
• 80% of incidental findings were not reported when the photo was omitted with the scan
• Radiologists reported a greater sense of empathy and care when evaluating the scan
• Duration of scan evaluation did not increase
Anecdotal comments included, “The patient photograph prompted me to relate in more detail to the CT” and “It enabled me to feel more of a physician.”
In other words, accuracy went up, empathy went up, sense of connection with the patient went up, and there was no additional time required. This is an example of innovation by connecting with the end result – with the purpose of the work.