Implementing resident-led radiology rounds: 3 key takeaways

Radiology rounds were once common, allowing radiologists and referring physicians to interact on a regular basis and discuss patient care. Today, however, they are largely a thing of the past.  

The authors of a new study published in Current Problems in Diagnostic Radiology noted that direct communication between radiologists and referring physicians has “dramatically decreased” since the widespread adoption of PACS, reflecting on how important “film rounds” once were to patient care.

“Radiologists had the opportunity to ask questions about patients’ clinical presentations while clinicians were able to appreciate how a detailed history assists radiologists in prioritizing a broad differential in cases with nonspecific or nuanced findings,” wrote lead author Andrew J. Klobuka, MD, with the department of radiology at the University of Pittsburgh Medical Center, and colleagues. “Discussion of appropriate next steps in imaging diagnosis and follow-up was easily carried out in this setting.”

Is this shift away from radiology rounds holding back radiologists and referring physicians? Could patients benefit if they returned?

Klobuka et al. implemented resident-led radiology rounds at a large academic medical center to see how diagnostic radiology (DR) residents and internal medicine (IM) trainees would respond. Nine months after implementation, the authors surveyed participants to see what they thought about the experience. These are three key takeaways from the group’s findings:

1. DR and IM residents agree: Radiologists should have regular face-to-face meetings with referring physicians.

Ninety-two percent of DR residents and 79 percent of IM residents said they “agree” or “strongly agree” that radiologists should meet face to face on a regular basis to discuss cases. And 96 percent of both DR and IM residents would like more “personal contact” between the two groups.

“It is not surprising then that both groups in our study desired an increased amount of personal contact between these groups in their day-to-day practice,” the authors wrote. “This represents a full-circle return by current residents who recognize and desire the benefits of ‘film rounds’ although largely having never experienced them in person.”

2. Most, but not all, DR residents want to spend more time communicating with referring physicians.

Most DR residents said they spend 5 to 15 minutes each day communicating directly with referring physicians. When asked how much time they’d like to spend each day, a majority answered that 15 to 60 minutes was the preferred amount of time.

On the other hand, 42 percent of DR residents said “increased contact would negatively affect workflow.”

3. IM residents say better access to radiologists would help them order appropriate exams.

Ninety-nine percent of IM residents said having access to radiologists—either through phone calls or in person—would help them ask questions about ordering appropriate exams and reading radiology reports. In addition, 99 percent of IM residents “agreed” or “strongly agreed” that a telephone directory full of radiology reading room phone numbers would be useful.

Klobuka noted that, in response to this feedback, the academic medical center implemented such a directory.

“The directory contained not only subspecialty reading room phone numbers but also contact information and a directory of whom to consult for common image-guided procedures,” the authors wrote. “Although this may not be practical for all radiology departments, anecdotal experience with our implementation has shown a decrease in the number of phone calls directed to the wrong reading room. Concerns over managing an increase in phone calls could be ameliorated via the use of reading room assistants.”