40 Methods: Reports (n=101) independently produced by 2 paediatric radiologists(PCR1/2) and a reporting radiographer(RR) were compared for agreement by 2 neonatal consultants, blinded to the origin of the report. Agreement was assessed using Kappa statistic. Results: A clinically significant discrepancy between reports was found in 1/3 of cases. Kappa(κ) demonstrated fair agreement for RR-PCR1/PCR2 κ=0.51, κ=0.35 and inter-PCR κ=0.36(p<0.001). Fair agreement was found between neonatologists; RR/PCR1/PCR2κ=0.31, κ=0.39 and inter- PCRκ=0.33 reports(p<0.001). This study demonstrates fair agreement, both for x-ray interpretation and neonatologists’ interpretation of the report. There was comparable agreement between the radiographer and radiologists. 14. QA 14.1. Improving diagnostic image quality for interpretation and safe storage within health facilities: Ruli Hospital case ( ISRRT 2012/Peter Lloyd Award 1st Place Winner) Presenter: Jean (John) Felix Habimana, Rwanda ministry of health(moh) / Ruli district hospital / Medical imaging department Author: Jean (John) Felix Habimana Introduction: Medical imaging is an essential part of the diagnosis of many diseases and plays an important role in the improvement of public health among all populations. Optimal diagnostic image quality (radiograph) is a fundamental element of x-ray image interpretation. It is also known that poor image quality is a major source of diagnostic error and can lead to misdiagnosis. Therefore, the implementation of quality assurance and management is a key pathway to accurate diagnosis. It is for that reason that the quality management mechanism was emphasized within the imaging department before integrating a systematic film reporting process. Problem Statement Poor equipment and infrastructure made it impossible to respond to an increase in patients exhibiting clinical signs that required precise musculo-skeletal and chest x-rays in order to ensure accurate diagnosis. It is well documented that not only will some abnormalities be misdiagnosed but many early pathologic features such as hairline fractures, any mild periosteal reaction, sclerotic changes, loss of smoothness of any hemi diaphragm, and small pulmonary nodules will be invisible on radiographs leading to misdiagnosis and patient mismanagement. In addition, it has generally been believed that diagnostic accuracy which corresponds to the outcome of radiologic examinations is related to image quality and other supporting factors which were not sufficiently in place. A number of medical imaging service challenges related to clinical problems for accurate diagnosis have been reported:..... Improved Department infrastructures for radiation protection facilities Accessibility of equipment Technical Aspects Methods: • Used critical observations :(CPBPFD)” • Developed tools for analyzing challenges identified and documented daily • Retrospective study(2001-2011), analyzed image quality based on theories learned in school prior to giving image to patient Results: Medical imaging service challenges related to clinical problems for optimizing patient care through accurate diagnosis based on medical imagining were reported. These included administrative issues and infrastructure. Ultimately, all basic facilities for patient-centered care were upgraded in a sustainable way. Ccl: Accurate diagnosis results from high image quality. 14.2. How can the nonverbal communication help our relationship with the patient? Presenter: Benoit Billebaut, Institut für klinische Radiologie, Universität Klinikum Münster (Germany) Authors: Benoit Billebaut & Francois Alric, Centre Hospitalier de Troyes (France) Introduction: There are many ways to communicate but it is always challenging in our jobs to establish a trusting relationship with a patient, particularly in the relatively short time that we have at our disposition. This relationship is of a primary importance, first so that the patient does not live the examination like a trauma and second to make sure that he/she will be as cooperative as possible. Time is short in today radiology and we seldom have the opportunity to take a lot of time to simply speak with our patients, to help them trust us. Words take too much of that valuable time, that is why it is important to master the other aspect of communication, one that doesn’t require this verbal component. It has been demonstrated that in trust matters, the nonverbal communication is as much as 80% more important the verbal aspects. Simply put: it matters more how we say something as what we say. Methods: First, we will introduce the basics of nonverbal communication and secondly we will demonstrate how a radiographer can use those to enhance his/her patient care. Our rules: it has to be easy, quick, universal and reliable. Results: With this presentation (20-30min), we aim to show how simple it can be to ease the patient examination stress and to help him/her see us as trusted professionals, if one is aware of the importance of nonverbal communication. Because this communication doest not rely on words, it is by its very nature international and be used in every radiology services in the world. 14.3. Simple measures to improve correct chest and abdomen imaging in NICU portable x-ray Presenter: Janni Jensen, Odense University Hospital, Denmark Author: Janni Jensen Introduction: For the infant in the neonatal intensive care unit (NICU) all medical procedures are of utmost and at times vital importance. Characteristic for bedside chest and abdomen imaging is that it must be performed fast, cause no or little stress to the infant and produce radiographs suitable for correct diagnosis. A radiograph may alter patient management and mistakes that could potentially affect the diagnostic accuracy must be kept at a minimum. Such a mistake could be, choice of beam orientation, positioning of the infant or how many images to take. When confirming correct positioning of a central venous catheter an AP supine chest radiograph is sufficient whereas both AP and lateral radiographs are essential when determining correct positioning of an umbilical venous catheter. At Odense University Hospital (OUH), the radiographers had access to a large detailed protocol containing guidelines, image criteria, images and in depth description on all relevant pathology. The protocol was meant to help the radiographers decide which images to obtain in the NICU. At OUH approximately 900 radiographic bedside examinations with numerous different pathologies are performed yearly on children between the ages of zero and three years. With more than 90 radiographers performing these examinations, a short readily available protocol with easy to understand guidelines was desired. The aims and objectives of this project was to raise the number of correct images by introducing a simplified one-page schematic protocol, derived directly from existing department protocol, leaving out all explanatory information, containing only essential knowledge. Methods: The effect of the new simplified guidelines was assessed by auditing the number of incorrect NICU images before and after introduction of the guidelines. 80 consecutive examinations were included in both audits. Results: The result of the first audit, already existing department protocol, was that 30% of the examinations differed from department protocol. The second audit was made three months after introduction of the simplified guidelines and the number of incorrect images had fallen to 13%, p<0.001 (Fisher´s Exact Test). Minimal intervention, such as simplifying already existing guidelines and making them available at all mobile x-ray units was enough to improve the number of correct examinations. 14.4. A Snapshot of a Week in Radiology Presenter: Adam Steward, Western Health, Australia Authors: Adam Steward, Stephanie Broeren, Michal Schneider-Kolsky, Louise Bentley Introduction: Radiology plays a vital role within the modern healthcare system; it involves communication between medical imaging staff, referrers and other hospital staff whereby clinical information is exchanged with the set goal of providing relevant, accurate and useful information in the diagnosis and treatment of a patient. There are worldwide studies that suggest communication problems in hospitals, between radiology and other departments, particularly with the ability to transfer and exchange important patient information. This leads to the question of ‘Are Radiology request forms being adequately filled out with all necessary information?’ and ‘Are radiologists providing useful information back to referrers?’ With this research project we hope to identify common inadequacies in communication with regards to the
ISRRT | Book Of Abstracts
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