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Difficulties and Possibilities in Communication between Radiologists and Referring Clinicians as seen by Radiologists Fatahi Nabi, Korpic Ferid, Hellström M Nabi Fatahi med dr., forskare, senior lecturer Nabi Fatahi 2010 Gothenburg University Aim To study radiologists' experiences of written and verbal communication with referring clinicians. Nabi Fatahi 2010 Gothenburg University Material Focus-group interviews with 12 radiologists, six women and six men aged 27-61 years with 1-27 years (median 10 years) experience, were carried out. Nabi Fatahi 2010 Gothenburg University Methods Main question: How do you experience communication, verbal and nonverbal, between the radiologists and the referring clinicians? What are the difficulties, what are the possibilities, and are there barriers in communication that can be overcome? Analysis Interviews were audiotaped and transcribed Content analysis was used for analysis and interpretation of the data. Nabi Fatahi 2010 Gothenburg University Difficulties and Possibilities in Communication between Radiologists and Referring Theme Clinicians -as seen by Radiologists Quality of written communication Qualisys of verbal Impact of Ethical Improvements of Communication economy aspects communication Categories Subcategories Insufficient Radiology Difficulties at Difficulties in Cost of Inadequate Trust and Better practical information on report radiology rounds individual examinations medical mutual routines priorities understandi request forms contacts ng Codes Patient data Structured or Participation Face-to-face Change of Symptom Increased Medical Amount of free text Clinicians contacts examination description contacts records access information Dictated or 'attention Phone type Medical Scheduled Time aspects Clinical questions typed report Conference contacts Time aspects urgency joint times Time aspects Change of meetings Anatomical Language priority Prescriber specifications barrier Patient´s education Abbreviations Nabi Fatahi 2010 Gothenburg University needs Quality of written communication Insufficient information on request forms “Sometimes they just write "abnormal findings?" and then you need to interpret the text of the request form to try to understand what type of pathology thy are really looking for so that we know what imeages to take”. ”I think it is very good to do the typing myself. That way I can formulate and correct myself instantaneously, and then feel that I can stand up for what I am writing.” Nabi Fatahi 2010 Gothenburg University Quality of written communication Radiology report “Sometimes they just write "abnormal findings?" and then you need to interpret the text of the request form to try to understand what type of pathology thy are really looking for so that we know what imeages to take”. Nabi Fatahi 2010 Gothenburg University Qualisys of verbal Communication Difficulties at radiology rounds Of course, it is disturbing if some participants are chatting while I am demonstrating cases.” Nabi Fatahi 2010 Gothenburg University Qualisys of verbal Communication Difficulties in individual contacts It can vary. It may take a few minutes if you're lucky and they are in the web-based phone directory, but it sometimes takes 50 minutes”. “ Nabi Fatahi 2010 Gothenburg University Impact of economy “A problem occurs when the request comes from outside, e.g. healthcare centers, and they ask for an examination while we think we should rather do a CT for better diagnosis. Then they may complain as they have to pay more than what was planned for. “ Nabi Fatahi 2010 Gothenburg University Ethical aspects “That they state that the examination is a little bit more urgent in order to avoid a long waiting time, and this disturbs the logistics and it may in fact result in too many examinations to be performed immediately, while you really need those time slots for acute examinations.” Nabi Fatahi 2010 Gothenburg University Improvements of communication Trust and mutual understanding “We should have meetings with clinicians, but it is difficult to get time over for this. I have planned a meeting with the orthopaedic surgeons here, but the time is just running out and there is no time over for such meetings”. Nabi Fatahi 2010 Gothenburg University Improvements of communication Better practical routines “At another hospital I often entered the patient webbased information system, so I could read e.g. about the patient´ s surgical history, but here I do not have access to this” Nabi Fatahi 2010 Gothenburg University Conclusion and practice implications Although communication between radiologists and referring clinicians generally functions well, a number of difficulties in verbal and non-verbal communication were highlighted. In order to reduce misunderstandings and problems in communication between radiologists and the referring clinicians, joint discussions on indications, methodology and routines, outside the regular scheduled clinical rounds should be implemented. Likewise, active educational activities, such as lectures, seminars and conferences, directed to the medical community at large, are needed to optimize the use of medical imaging. Nabi Fatahi 2010 Gothenburg University