Background

Emotional harm incidents in health care may result in lost trust and adverse outcomes. However, investigations of emotional harm in radiology departments remain lacking.

Purpose

To better understand contributors and clinical scenarios in which emotional harm can occur in radiology, to document incidences, and to develop preventative countermeasures.

Materials and Methods

A large tertiary hospital adverse event reporting system was retrospectively searched for submissions under the category of dignity and respect in radiology between December 2014 and December 2020. Submissions were assigned to one of 14 categories per a previously developed classification system. Root-cause analysis of events was performed with a focus on countermeasures for future prevention. The person experiencing emotional harm (patient or staff) was noted.

Results

Of all radiology-related submissions, 37 of 3032 (1.2%) identified 43 dignity and respect incidents: failure to be patient centered (n = 23; 54%), disrespectful communication (n = 16; 37%), privacy violation (n = 2; 5%), minimization of patient concerns (n = 1; 2%), and loss of property (n = 1; 2%). Failure to be patient centered (n = 23) was subcategorized into disregard for patient preference (12 of 23; 52%), delay in care (eight of 23; 35%), and ineffective communication (three of 23; 13%). Of the 43 incidents, 32 involved patients (74%) and 11 involved staff (26%). Emotional harm in staff was because of disrespectful communication from other staff (eight of 11; 73%). Seventy-three countermeasures were identified: staff communication training (n = 32; 44%), individual feedback (n = 18; 25%), system innovation (n = 16; 22%), improvement of existing communication processes (n = 3; 4%), process reminders (n = 3; 4%), and unclear (n = 1; 1%). Individual feedback and staff communication training that focused on active listening, asking for the patient’s preferences, and closed-loop communication addressed 34 of the 43 incidents (79%).

Conclusion

Most emotional harm incidents were from disrespectful communication and failure to be patient centered. Providing training focused on active listening, asking for patient’s preferences, and closed-loop communication would potentially prevent most of these incidents.

© RSNA, 2021

See also the editorial by Bruno in this issue.

中文翻译：

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放射科的情绪伤害：一个未被充分认识的可预防错误的分析

背景

医疗保健中的情绪伤害事件可能导致失去信任和不良后果。然而，仍然缺乏对放射科情绪伤害的调查。

目的

为了更好地了解放射学中可能发生情绪伤害的贡献者和临床场景，记录发生率，并制定预防性对策。

材料和方法

在 2014 年 12 月至 2020 年 12 月期间，对一家大型三级医院不良事件报告系统进行了回顾性搜索，以寻找放射学尊严和尊重类别下的提交内容。根据先前开发的分类系统，提交内容被分配到 14 个类别之一。对事件进行根本原因分析，重点是未来预防的对策。记录了遭受情感伤害的人（患者或工作人员）。

结果

在所有与放射学相关的提交中，3032 份中的 37 份（1.2%）确定了 43 起尊严和尊重事件：未能以患者为中心（n = 23；54%）、不尊重沟通（n = 16；37%）、侵犯隐私（n = 2；5%），最大限度地减少患者担忧（n = 1；2%）和财产损失（n = 1；2%）。未能以病人为中心（n= 23）被细分为无视患者偏好（23 人中有 12 人；52%）、护理延误（23 人中有 8 人；35%）和无效沟通（23 人中有 3 人；13%）。在 43 起事件中，32 起涉及患者（74%），11 起涉及工作人员（26%）。员工的情绪伤害是因为其他员工的不尊重沟通（11 人中有 8 人；73%）。确定了 73 项对策：员工沟通培训（n = 32；44%）、个人反馈（n = 18；25%）、系统创新（n = 16；22%）、改进现有沟通流程（n = 3 ; 4%)、处理提醒 ( n = 3; 4%) 和不清楚 ( n= 1; 1%）。以积极倾听、询问患者偏好和闭环沟通为重点的个人反馈和员工沟通培训解决了 43 起事件中的 34 起 (79%)。

结论

大多数情感伤害事件来自不尊重的沟通和未能以患者为中心。提供专注于积极倾听、询问患者偏好和闭环沟通的培训可能会预防大多数此类事件。

© 北美放射学会，2021

另见本期布鲁诺的社论。