The ‘reclusive radiologist’: Imaging-led rounds key to cross-specialty collaboration, patient care
As hospital reimbursement moves toward value-based payment models, radiologists will need to get more involved in patient care. One group of experts recently found that radiology resident-led medical rounds proved to be a valuable solution.
Researchers created such a project, in which year four radiology residents led internal medicine residents during weekly rounds, and shared their experience June 1 in Current Problems in Diagnostic Radiology.
Over the course of the 2017-2018 academic year, the imaging specialists walked their colleagues through inpatient units, discussing indications for ordering imaging studies, ordered further imaging workups, and taught the basics of interpretation, all with a focus on evidence-based clinical decision support.
After 10 months, residents were offered a questionnaire to gauge their experiences.
The response rate was low—34 out of 161 individuals—but overly positive, according to Adam E. Goldman-Yassen, MD, with Children’s Hospital of Philadelphia’s neuroradiology division, and colleagues.
“Although opportunities for structural improvement exist, medicine residents desire more direct interaction with radiologists,” the group wrote. “Our data show that in-person, resident-led rounds with medicine residents improves patient care, ordering practices, and inter-specialty relationships.”
Below are a few specific takeaways from the survey:
- Thirty-one percent of internal med residents could spot a situation where the rounds changed patient management. And a whopping 94% said it increased their medical knowledge.
- Most (61%) said their evidence-based choice for imaging orders improved by attending the radiology-led rounds, while 64% became more aware of resources to inform such orders.
- The rounds also improved how residents viewed imaging, with 39% claiming a change in their perception of radiologists’ role in the care continuum.
- Seventy-five percent said they want to see rads more involved in their daily workflow.
From here, Goldman-Yassen et al. believe there are many paths toward further expanding direct radiology involvement in patient care. A “natural progression” they wrote, would be to embed a radiology resident within the medical team on daily clinical rounds.
“Being present at the time of clinical decision making would maximize the consultant radiologist's impact on clinical case management and answer questions regarding the ordering of imaging and other tests,” the authors argued, adding that it would also give rads an opportunity to discuss imaging findings face-to-face with patients.
They also pointed to radiology outpatient clinics or embedded reading rooms to bring imaging experts closer to referring clinicians and patients. All in all, the authors say the time has come to bring together clinical teams and the “reclusive radiologist.”
“It is…important and valuable for radiologists, including those in training, to participate in endeavors to that increase face-to-face interactions with referring clinicians and patients, and more directly impact patient care,” they concluded.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.