Improving Communication, Collaboration, and Faculty Comfort in Communicating Difficult News in the Pediatric Radiology Department.

OBJECTIVE: When an unexpected or significant diagnosis is made while imaging a child, the pediatric radiologist and support staff are placed in the middle of a life-changing event for the patient and family. The process by which this situation is handled can be quite variable in part because of the lack of a preexisting relationship between the pediatric radiologist and the patient and family. Therefore, we developed a program to improve effective communication of unexpected or significant diagnoses to families called the Difficult News Program. CONCLUSION: By defining and coordinating roles, the Difficult News Program improves communication between radiology staff and other health professionals and families and optimizes the patient and family experience during an emotional and difficult time. The defined roles and teamwork approach allow timely, compassionate, and accurate information to be shared with families.

Improving health literacy: use of an informational brochure improves parents' understanding of their child's fluoroscopic examination.

OBJECTIVE: The purpose of this study was to determine parents' knowledge about pediatric fluoroscopic procedures and potential risk from ionizing radiation before and after being given an informational brochure. SUBJECTS AND METHODS: We reviewed responses from 120 randomly selected participants who were parents or guardians of pediatric patients undergoing diagnostic fluoroscopic examinations. A questionnaire assessed participants' knowledge of the procedure, radiation exposure, and whether their child had a prior examination before and after receiving an informational brochure. In a feedback survey, participants rated the brochure. A repeated measures mixed model was used to evaluate the effect of the brochure on the participants' knowledge. RESULTS: Participant demographics were women (79%), English speaking (99%), white (90%), and education higher than 12th grade (76%). The median age of patients undergoing the fluoroscopic examination was 4 years. Participant knowledge increased (p < 0.0001) between pre- and postbrochure (least-squares means) for those without a previous examination from 38.3 to 63.4 (total test score) and from 46.3 to 61.8 for those with a prior examination. The proportion of correct answers was higher (p < 0.0001) postbrochure compared with pre-brochure in areas of examination name (99% vs 93%), procedure details (97% vs 87%); use of radiation (100% vs 68%), and radiation dose comparison (79% vs 25%). Overall, 99% (119/120) rated the brochure "good" or "great" (p < 0.0001). CONCLUSION: An informational brochure given to participants before their child's fluoroscopic procedure improved their knowledge of the examination and radiation exposure. No participants refused their child's examination.