Improving the imaging experience of patients with PTSD

A quality assessment and improvement project at the Veterans Affairs Puget Sound Health Care System in Seattle revealed the need for optimization of the imaging experience of patients with posttraumatic stress disorder (PTSD) and a viable area for improved awareness and future research, according to a feature published in the June issue of the Journal of the American College of Radiology.

Many patients with PTSD require diagnostic imaging for workup of medical problems, yet radiologic examinations could invoke anxiety, fear or discomfort in this demographic. Lead author Jessica C. Germino, MD, of the University of Washington in Seattle, and colleagues conducted a quality assessment and quality improvement project to evaluate the institution’s preparedness to serve patients with PTSD and identified steps to improve the imaging experience of the population in the future.

The project included a survey of 50 staff members regarding their personal experiences with PTSD, knowledge of the disorder and comfort level at adequately and safely meeting that population’s needs. The researchers then evaluated whether their department effectively utilized existing resources within the Veterans Affairs system. After consulting with colleagues in the Department of Psychiatry and Behavioral Sciences, the authors were taught how to recognize symptoms of PTSD and how to better support these patients. Protocols and procedures of a code green were also taught for a behavioral emergency.

Finally, a departmental staff training session was organized in collaboration with a psychologist with PTSD expertise and a Veterans Affairs Police sergeant to relay the findings and offer additional staff training.

Of the 50 distributed surveys, 40 were returned. On average, respondents were unsure of their ability to recognize PTSD symptoms and uncertainty about their preparedness to work with patients with PTSD. Notably, residents and fellows reported lower levels of comfort and preparation than other participant groups.

The authors suggested creating an abbreviated protocol for MRI with the goal of identifying patients at risk for anxiety or stress reactions to increase the likelihood of successful completion of radiologic exams.

“We believe optimizing the imaging experience of the patient with PTSD is a valuable area for improved awareness and future research,” the authors concluded.