Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study

A case report of system configuration issue in medical imaging due to system upgrade- changes in hardware and software

Although the rapid growth in the efficiency of medical imaging is undeniable, the expansion of health information technology (HIT) into medical imaging has not been as seamless or well-integrated as it was thought to be. The socio-technical complexities in medical imaging associated with HIT systems can cause risks to patient harm and inconvenience, both individually and collectively, often in new, unforeseen, and unexpected ways. This study reflects a retrospectively collected single incident report related to medical imaging HIT systems, aiming to develop a set of preventive and corrective strategies. A combination of multiple deductive approaches (existing frameworks), i.e., HIT Classification Systems and 18-step medical imaging process workflow and inductive method (content analysis), were used to analyze the incident. The incident was identified as a "system configuration"-related software issue, contributed by system upgrade- changes in hardware and software. The incident was determined to occur during steps 10-12, i.e., "study selection and retrieval," "calling up of patient's referral," and "image review and interpretation," causing severe disruptions in the clinical workflow for several weeks. We propose 16 preventive and corrective strategies grouped under four key areas based on the socio-technical aspects associated with HIT systems. The key areas are (i) preparation and integration for upgraded systems, (ii) training for medical imaging specialists, (iii) contingency planning/immediate backup system, and (iv) system design and configuration. These strategies are expected to help healthcare staff, analysts, reporters, researchers, and relevant stakeholders improve care delivery and patient safety in medical imaging in the context of any system upgrades.

Radiographers' perspectives on interactional processes during older persons diagnostic medical imaging encounters: a qualitative study

BACKGROUND

Within a diagnostic medical imaging context, an interaction encompasses communication, physical contact and emotional support. These intricacies are an integral part in achieving a successful medical imaging outcome. An increasing ageing population presents unique challenges and leads to a higher demand for medical imaging services. There is a paucity of literature exploring the specialised knowledge and skills required by radiographers to service optimal person-centred care for elderly patients. The purpose of the study was to explore radiographers' perspectives on interactional processes during older persons diagnostic medical imaging encounters.

METHODS

The study used a qualitative exploratory research design with a descriptive approach to gain insights from 12 purposively sampled Australian radiographers, through open-ended interviews conducted online or by telephone. Verbatim transcripts were produced, and a thematic analysis employed until data saturation had been reached.

RESULTS

The three themes that emerged from the data analysis were: (1) optimising care and communication, (2) expectations and preconceptions and (3) physical and emotional comfort and safety. Generally, the approach to undertaking older persons examinations entailed more adaptive and flexible competencies and skills in comparison to the familiarised routine diagnostic medical imaging encounters with the younger cohort. Radiographers shared aspects on striking a balance between efficiency and proficiency with the elderly patient needs, preferences, values, safety and well-being considerations. This required swift, complex decision-making and judgement calls due to the unpredictable nature of the context in which the elderly person was situated. The result was the adaptation of examination protocols through equipment manipulation, with minimal disruptions to emotional and physical comfort, achieved through interventions and support strategies.

CONCLUSION

The results highlight the many considerations for radiographers during a short clinical interaction. There is optimism in adding value to the elderly persons experience through a complex interactional process. It is anticipated that the identified skills will inform on best practice principles to achieve an elderly person-centred care medical imaging outcome.

Radiographers' perceptions on the quality of managing general radiographic paediatric examinations through the use of a reflective tool

INTRODUCTION

Paediatric patients are a vulnerable population that require additional care by healthcare professionals. Quality managing these examinations ensures that effective and quality care is provided to individual patients, whilst encouraging consistency within the medical imaging department. This study explored radiographers' perspectives on quality management strategies of general radiographic paediatric examinations using a paediatric imaging reflective checklist.

METHODS

A quantitative descriptive research design with qualitative questions was used through a purposive sampling method from both public and private Australian diagnostic imaging qualified radiographers who had experience in paediatric imaging examinations. The paediatric imaging service reflective tool consisted of 65 items in total. Data analysis entailed Microsoft Excel version 16.16.6 and Jamovi version 2.3.21 for the closed-ended questions and for the open-ended responses a thematic analysis.

RESULTS

The participation rate was 13.2% and the most significant findings were: lead shielding was still being used at their organisation, despite recent recommendations to suspend its use; access to paediatric patient related information resources is limited; there was no involvement of families and communities regarding policy development or quality improvement measures as advocated in literature; and there was a need for enhanced specialised paediatric education, training and protocols.

CONCLUSION

Using the paediatric patient-centred imaging reflective checklist, radiographers had an opportunity to identify quality improvement indicators as well as issues that could further enhance best practice principles. Further studies could inform on the validity of this reflective tool.

Effects of a 360° virtual counselling environment on patient anxiety and CCTA process time: A randomised controlled trial

INTRODUCTION

This study investigated whether a 360° virtual counselling environment (360°VCE) was more effective at decreasing patients' anxiety than routine standard of care counselling for patients undergoing coronary computed tomography angiography (CCTA), and if there was any difference in the process times for both of these groups.

METHODS

A total of 86 patients underwent CCTA in this randomised controlled trial. Patients were randomly assigned to intervention and control groups. The 360°VCE was developed using spherical panoramic images and non-immersive 360° technology. The primary outcome, anxiety, was measured using the State-Trait Anxiety Inventory (STAI). The secondary outcome, CCTA process time, was measured from the time of arrival in the department until end of examination.

RESULTS

Pre-scan anxiety was lower among patients in the 360°VCE group immediately before CCTA in comparison to patients in the control group (p = 0.015). Women demonstrated higher levels of anxiety than men in both groups. No between-group differences were discerned in CCTA process time.

CONCLUSION

Access to 360°VCE can reduce patients' pre-CCTA anxiety levels.

IMPLICATIONS FOR PRACTICE

The presented results can be used to improve patient counselling and care, reduce anxiety among patients undergoing CCTA, and optimise the CCTA examination procedure.