5 tips for rolling patient-centered care into radiology

Radiology departments and practices can incorporate principles of patient- and family-centered care (PFCC) into clinical operations without hampering productivity. Every upgrade to radiology equipment and environment represents a new opportunity to engage patients and their families. And PFCC is “a collaborative process—a journey, not a destination.”

These are among the take-home points offered for consideration in an article running in the December edition of the Journal of the American College of Radiology.

Drawing from 20 years of experience with PFCC, James Rawson, MD, and colleagues at the Medical College of Georgia at Augusta University define PFCC as the incorporating of input from patients and their family members into operational decisions.

They note that, in the present volume-to-value era, patients and family members are “evolving from passive recipients of care processes determined by doctors and other clinicians to active partners in decision making and value determination”—a development that has ramifications for reimbursement.

The Georgia team, along with co-author Becky Haines of the ACR, share numerous granular pointers they’ve picked up over the past two decades. (“Warm blankets make everything better” ... “Children learn by playing” … “Diagnostic radiology can be a healing environment.”)

Also: “PFCC is a journey without a destination. You are always working to improve while the target moves.”

Their suggestions for radiology departments and practices looking to launch PFCC endeavors include:

1. Recruit patient advisers who can advocate for more than just their own point of view. Patient advisers who helped guide a redesign project at Children’s Hospital of Georgia proposed acquiring artwork from local artists depicting scenes of South Atlantic beaches, lighthouses and other regional views. “The local images were specifically chosen by patients because they elicited discussions of their family vacations and experiences that other patients likely share, creating conversation starters,” the authors explain.
2. Create environments in which people can openly comment on what you are not doing well so that you can improve it. Listening to patients’ needs and wants while they undergo examinations can result in higher satisfaction and better outcomes, the authors point out.
3. Look for opportunities to engage patients and families. Asking patients and family members for input has to be done prudently and judiciously. Then again, productive engagement can happen outside care processes, the authors underscore. “Diagnostic radiologists may spend most of their day reading imaging studies in a dark room,” they add, “but that does not prevent them from helping a lost patient or family negotiate an unfamiliar hospital hallway or taking a minute or two to visit the waiting room to converse with patients.”
4. Don’t wait for someone else to take the lead. “Without courageous early leaders at the Medical College of Georgia taking a risk to accomplish their vision of PFCC, we would not have two decades of success stories to share,” the authors write. “In our case, leadership and long-term commitment to the principles [of PFCC] … created cultural continuity that has been key to a decade of award-winning quality care.” (Among the awards they’ve won are HealthImaging’s Patient-Centric Imaging Awards in 2013 and 2015.)
5. Build inclusive teams. Bring in not only patients, families and advisers but also employees. “Inclusion of frontline staff members in the design process validated the importance of their work and their insights,” the authors write. “In our experience, an engaged staff creates a better experience for patients.”

Rawson, who serves as chair of the ACR’s patient-experience commission, and colleagues maintain that the greatest value they’ve gleaned from practicing PFCC is not the final product of any single project but the culture change that has occurred along the way.

“We saw changes in the people who participated in the projects and ultimately a transformation of the culture of an academic radiology department to be more patient and family centered,” they write. “Through changes in leadership, organizational structure, and payment systems, PFCC continued to be a core value of our department.”

“PFCC is a long journey; it is part of a successful strategy that includes inclusive management, fiscal responsibility and process improvement.”