“Radiology is very much a customer service-oriented industry,” said Dr. Alexander Towbin, radiologist and associate chief of clinical operations and informatics at Cincinnati Children’s Hospital Medical Center. “We are often the intermediaries of referring providers and patients and we are managing the expectations of both.”

First and foremost, he believes being an excellent intermediary is the core of any successful pediatric radiology department or practice. Many radiology subspecialities don’t attract their own patients so they rely on ordering providers to refer patients to them.

These departments and practices also rely heavily on the patients and their parents. It’s important to keep them happy so they will want to come back and perhaps even recommend friends and family members to the facility.

Keep the kids happy
Some procedures, especially the invasive ones, are uncomfortable; so it’s vital to explain the procedure to the children using language that’s at the appropriate development age. It’s also imperative to design a child-friendly environment, which means having up-to-date decorations, video goggles, modern entertainment options and Child Life specialists.

These specialists are experts in childhood development and child play at appropriate ages. They interact, communicate and play with the children throughout fluoroscopy and nuclear medicine exams as well as MR exams, when the facility wants to decrease the use of sedation.

“It’s great to have stickers and stuff, but kids want to play on tablets,” said Towbin. “Having an iPad or other tablets to play on while they are undergoing tests lets them watch videos or play games.”

He added that it’s important to also have ways to distract children with special needs. For instance, children with autism require different toys and distractions than children without the condition.

Emphasis on empathy
“Radiologists are often the first people to diagnose bad things like cancer,” said Towbin. “We are often the ones who have to break the news to families. It’s a terrible, life-changing moment for any parent to get that news.”

He added that it’s the facility’s job to provide this news in a manner that is respectful and best supports the family. When he makes a diagnosis on an ultrasound, he immediately calls the oncologist, ordering provider and CT or MR technician so that everything is lined up before talking with the family.

His facility also offers private rooms for the families to discuss things after receiving the news. It’s during that time that they can ask the questions and take in the information, while the support staff distract and play with any children that may be present.

Happy child means happy parent?

Towbin said that is not necessarily the case.

“If we have a kid here for an upper gastrointestinal test because they are throwing up all the time, I can keep them happy for that test,” he said. “The result may be normal and the parent [might be] unhappy because we don’t have an answer to explain why their kid is throwing up.”

When it comes to interpersonal interactions, a facility may do a good job of interacting with a child, but unintentionally say something off-putting to the parent. In that case, the child might leave happy, but the parent is unhappy.

One potential way to ensure parents are happy is to allow them to see the results of a test right away. Towbin explained that the results traditionally go to the ordering provider and then are delivered to the patients or parents, but now the parents want access to those results immediately.

At his facility, they offer the results via the EMR portal with either no embargo or a 48-hour embargo. In some cases, an embargo is needed because oncology wants to review the results and discuss things first.

“The next step is letting them see the pictures,” said Towbin. “It’s more than just a report – we spent all this time and they spent all this money to get their images taken and they should have access to see them. We are working on that now because that is where we want to be.”