Abstract
BACKGROUND AND PURPOSE: Effective communication among health care providers within an institution is vital for ensuring patient safety. A radiologist’s competence in identifying critical findings is just as important as being able to relay this information to the primary provider in a timely manner so that appropriate interventions can be initiated in life-threatening emergencies. This study aims to obtain baseline data regarding effective communication of critical findings between radiology and the primary health care providers.
 
 MATERIALS AND METHODS: Based on the Massachusetts’s Coalition for Prevention of Medical Errors safe practice recommendations, a communication protocol was developed. Certain selected cranial critical findings (new hemorrhage, new herniation, acute brain edema, acute stroke and findings suggestive of meningitis or abscess) were used in the critical findings protocol. Total communication time (TCT) in the relay of critical findings included time from CT scan order to scan (OS time), time from scan to interpretation (SI) and time from interpretation to relay (IR). All these times were recorded and compared to the standard 60 minutes using percent compliance, mean time, median time and standard deviation.
 
 RESULTS: Seventy-nine (79) critical findings were recorded and relayed in a 30-day period. There was 100% (79/79) compliance with the relay of critical findings to the primary care team and 97.5% (77/79) success rate in direct communication of critical findings within 60 minutes of identification. The mean OS time was 155.09 (±134.43) minutes, mean SI time was 46.54 (±44.01) minutes, and mean IR time was 9.13 (±12.04) minutes. The average time elapsed from CT study acquisition to direct notification was 57.0 (± 45.80) minutes.
 
 CONCLUSION: Effective communication of critical findings using a protocol adopted from set standards of safe practice recommendations is achievable in our institution. The proposed protocol exhibited compliance to and performed well against established benchmarks. The timely identification and delivery of critical findings to the primary care team is central to patient management and should be practiced in our setting.
 
 Keywords: critical finding, effective communication, cranial CT, standards
Highlights
Clear and effective communication between physicians is of utmost importance in delivering quality patient care - that is, optimum care in a timely manner
In the Critical Findings Reporting in Cranial CT Scans PGH, a CT team is composed of at least 6 residents at any given month- 5 senior residents and at least one junior resident
The times were well within standards and comparable to times obtained in other institutions
Summary
Clear and effective communication between physicians is of utmost importance in delivering quality patient care - that is, optimum care in a timely manner. In research done by Woolfe et al, approximately 80% of errors stemming from miscommunication between medical practitioners led to a cascade propagating diagnostic and treatment mistakes [3] It is, crucial that radiologists interpret images accurately and effectively communicate these findings to those responsible for treatment decisions. A well-reviewed and tested communication system is critical in providing the standard of care in any medical care facility For this reason, The Joint Commission in 2011 placed communication of critical results as a priority goal for its National Patient Safety Standards in the United States [5]. Using a protocol adopted and modified from the Massachusetts Coalition for the Prevention of Medical Errors’ safe practice recommendations for the communication of critical radiology findings published in TJC’s Journal on Quality and Patient Safety, and a study done by Viertel et al in reporting critical findings in neuroradiology, we selected
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