Radiologists want more positive feedback, emotional support following major errors
Making a serious medical error can be a crushing experience for radiologists that’s only exacerbated if practices don’t have the right safety net in place.
This, in turn, can lead to a “vicious cycle of emotional burnout and future error,” experts wrote Monday in Academic Radiology. Wanting to better understand and address this phenomenon, researchers recently surveyed almost 300 radiologists, looking for clues to close this cycle.
The takeaway: radiology practices must work to foster trust in quality assurance programs, incorporate more positive feedback and improve emotional support.
“Our study demonstrates that the majority of radiologists experience negative emotions after being notified of a major error,” lead author Christine Lamoureux, MD, a musculoskeletal specialist with vRad, and colleagues wrote March 2. “This indicates that strong negative emotions after a major error have the potential to create an environment of reciprocal vulnerability in the radiologist quality-assurance committee relationship, particularly those with higher error rates, and that more support resources may be needed,” they added later.
To reach their conclusions, Lamoureux and colleagues conducted an online survey of 291 radiologists employed by vRad—an Eden Prairie, Minnesota-based teleradiology firmed owned by Mednax. The goal, they wrote, was to unearth physicians’ opinions about their own quality assurance program, and actions taken after adverse events.
They found the majority of radiologists experience negative emotions after a mistake, including feeling discouraged (85%), less satisfied with their job (75%) and a negative mood at home (74%). Many also experienced a dip in confidence (74%) and increase in depression (70%).
Diving into the reasons for mistakes, about 87% believed most misses were on the basis of errors of perception, rather than interpretation. And nearly 95% said their errors stemmed more from “under calls” rather than “over calls”—rendering an unnecessarily abnormal diagnosis. Sleep deprivation (63%), too many hours/days worked (61%), distractions (57%) and work stress (52%) were pinpointed as some of the top self-identified risk factors, survey respondents said.
And following an error, some of the most common actions taken by radiologists included changing their search pattern (90%), slowing reading speed (83%), removing distractions (56%) or doing related education activities (39%).
Despite negative emotions that bubbled up after making a mistake, most radiologists in the survey seemed to favor the quality assurance processes. Almost 90% believe QA helped them learn from their mistakes, is necessary (85%) and made them a better radiologist (75%).
Still, slightly less than half felt they trusted the process; 81% said they don’t get enough positive feedback; and only 45% were OK with the amount of emotional support.
“In response to the results of our survey, our practice has launched an initiative to increase transparency of the QA process and to increase the amount and frequency of positive feedback to radiologists,” noted Lamoureux and colleagues. “Our results must be cautiously translated to onsite radiologists,” they cautioned.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.