We had the pleasure recently of hearing an outstanding e-lecture on “Improving the Clarity and Impact of Radiology Reports’ by Professor Michael Bruno, who is Professor of Radiology and Medicine and Director of Quality Management and Patient Safety for the Department of Radiology at the Penn State Milton S. Hershey Medical Center, in Hershey Pennsylvania. A graduate of Johns Hopkins, Prof Bruno has written a book on Quality and Safety in Radiology and chairs the Core Committee for Quality and Safety for the American Board of Radiology. He serves on the Expert Panel for Musculoskeletal Imaging for the American College of Radiology, and the ACR RadPeer Committee, as well as the e-learning committee of the American Roentgen Ray Society and the Policy & Practice Committee of the Radiological Society of North America.
His recent article in the JACR was subsequently the subject of a Wall Street Journal article on the subject.
Dr Bruno’s lecture was truly a tour de force and almost had me dancing in the aisle of our auditorium as he made point after point that completely resonated with what I myself emphasize in the training sessions that I conduct.
Among the salient points of his talk:
1. Only 50% of clinicians actually read anything other than the impression of the report
2. Voice recognition although a valuable productivity tool, can also be a hazard, as a misrepresented word can completely change the context.
3. Concise reports are more effective
4. Always answer the clinical question
5. Do not be afraid to use the word normal
6. Avoid unnecessary hedging or recommending unnecessary follow up tests.
7. Use structured formats and standard lexicon, without abbreviations
8. Attention to grammar is essential to avoid confusion.
What I especially liked about Dr Bruno’s talk was that he presented an analogy of how a report is like a composition by Mozart which has just the right number of notes or a sonnet by Shakespeare with just the right number of words. In other words, science meets art.
In radiology reporting as in everything else, there is therefore the potential to achieve perfection, and as radiologists we should constantly aspire to achieve this goal.