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Radiology: Coming Back After COVID-19

When it became clear that the novel coronavirus, COVID-19 would become top priority to detect and treat in patients around the globe, hospitals and health systems were forced to abandon their typical annual plans for operational growth and budget goals to deal with the crisis at hand. Most facilities, in order to prioritize care for COVID-19 patients and also minimize the spread of the disease, shut down all non-essential surgeries and outpatient procedures, including medical imaging. Now that many facilities are reopening these services, they are finding that many patients are afraid to return to the hospital or outpatient imaging setting. In order to share some key learnings and practices that were developed during the height of the crisis, GE Healthcare created a series of webinars where radiology clinicians and experts in communications share their experiences dealing with COVID-19, and their strategies for reopening, and reestablishing trust with their patient communities. They share tips and experiences creating pandemic communications that proved successful during the height of the pandemic, and what they plan to do moving forward to fully reopen patient services.    

Building a Rollout Plan: Emerging from COVID-19

The first in a series of seven webinars, “Building a Rollout Plan” is moderated by GE Healthcare’s Todd Minnigh, Chief Marketing Officer of GE Healthcare X-Ray, and brings together Shrikanth Jaikumar, Vice President of Ambulatory Services and Program Development at JFK Medical Center, Hackensack Meridian Health, in Hackensack, New Jersey, and Amanda Garlock, Imaging Quality, Training, & Safety Supervisor at Providence Regional Medical Center Everett in Marysville, Washington. They discuss their experiences dealing with the onset of the crisis from opposite coasts of the US, and how they worked to make changes in their facilities to screen for COVID-19 and make accommodations for COVID-19 positive and suspected positive patients. When Dr. Jaikumar’s facility considered reopening, many steps needed to be taken to do that successfully.

“We have a large, 17 hospital system and imaging network. We designed an outpatient testing restart process map, and we created this process map together so there would be some level of standardization in how we approached reopening,” Dr. Jaikumar explained. “We wanted to instill a level of confidence with patients, so they are not afraid to come back. Toward this end, we walked through every site and created journey mapping, to see how patients would interact with staff and get a feel for what our interactions would be with patients so we could mitigate any social distancing and/or contact precautions that we should be taking when we reopened.”

The completed process included staffed stations for patients to answer screening questions once they arrive. All patients would be asked to complete hand hygiene and would be given a surgical mask. Patients’ ID cards were even placed into a plastic bag and were copied that way to reduce the need for handling by staff. The team also detailed new procedures for room cleaning, disinfecting high-touch surfaces and cleaning portable equipment, such as X-ray.

On the other coast, Providence Regional Medical Center, did not shut services down, but was able to create different physical spaces for COVID-19 positive or suspected positive patients.

“We never actually stopped our outpatient imaging,” explained Ms. Garlock, “except for screening mammography and lung cancer screening. We let our outpatient appointments organically drop off.” In either scenario, hospitals and health systems have lost a shocking 60-80 percent of their operating budgets because of the  drop-in elective surgeries, imaging and screening procedures.

Bringing back elective services, hospitals are finding that fear of contracting the virus is keeping patients away, and even worse, caused some people to defer urgent and critical care during the initial wave of the virus.

“So now, as we fully reopen, we want to stress the importance of coming in to get care,” said Ms. Garlock. “Patients shouldn’t need to evaluate the level of their own emergency versus their fear of catching the virus.”

Creating a Positive Patient Experience Post COVID-19

As outpatient services and imaging centers began fully reopening, many prioritized those patients whose procedures had now become time sensitive. In a second webinar, “Patient Anxiety and Expectations,” GE Healthcare’s Global Product Marketing Director for X-Ray, Megan Riddle-Fulton speaks with Mossa Basha, MD, Chief of Radiology at the University of Washington and NWH Medical Centers and Chris Tomlinson, Enterprise Vice President of Radiology/Imaging, Clinical Lab & Pathology, Emergency & Hospital Medicine Service Lines at Jefferson Health in Philadelphia about their experiences getting patients back into their facilities for services or procedures.

“We’ve been reaching out to patients in a number of ways,” explained Dr. Basha. “We have signs throughout our facilities detailing the safety precautions we’re taking, and we also created a video that we shared on social media.”

Mr. Tomlinson shared similar experiences, and specifically noted that patients were reluctant to return, despite communication efforts. “We noticed via our scheduling call center that some patients were very anxious to get back and get their testing, but some had to be prompted. I’m fearful that a ‘second pandemic’ will be all the care that was deferred.”

Jefferson Health also created a video message that celebrated their safety and very limited spread of the virus within the hospital system. The leadership team is focusing on setting expectations and empathy around patients’ anxiety. Both webinar speakers conveyed they are working hard to convey that the hospital is a safe place and that patients shouldn’t wait on their care.

X-Ray and Patient Fears

To support radiologists as they continue to provide care to patients, GE Healthcare conducted a survey of patients’ experiences and expectations related to X-Ray services. The survey was first conducted in February of 2020, but was repeated in May, with additional questions in light of the pandemic. Ms.  Riddle-Fulton reported that two main themes emerged from the surveys. In the initial survey, respondents reported what they value most about their X-Ray experience is the human connection they have with the technician to allay their fears and answer their questions. The second response to highlight is that people strongly the changes made during the pandemic related to safety and disinfection procedures in hospitals should remain in place after the pandemic crisis is over. Patients said they would feel more comfortable with the continued use of personal protective equipment (PPE) by technologists, hand hygiene and social distancing measures.

Webinar participants unanimously felt that with standard safety protocols in place, radiology technicians will continue to operate with the emotional intelligence necessary to assess the anxiety of patients and their feelings of risk. Exam time will vary from patient to patient.

They also agreed that in addition to the hygiene policies, some of the other changes made during the crisis will likely be more permanent going forward. New communication platforms and telemedicine appointments, for example, will likely continue. There is a convenience with telemedicine appointments that patients as well as physicians can appreciate.

Radiology and Pandemic Communications

As new communication models emerged during the pandemic, communications with patients had to take on a new focus to speak to patients about safety precautions, new protocols and procedures with respect to telemedicine, and what to do in emergency situations. Third in the webinar series, “Pandemic Communications” brought together healthcare executives and communications experts to share best practices on communications during the pandemic.

Tricia Garrity, Chief Marketing Officer at Children’s of Wisconsin, shared her experiences during the webinar. “It was truly an awe-inspiring experience how our staff was able to make decisions so quickly, maintain focus, and adhere to our guiding principles. We needed to communicate to patients about which locations were open for what services, and how patients could access care. We had to change our goals almost overnight.”

Ms. Garrity told listeners that the hospital had begun preparing at the start of 2020 to convert to telehealth. Their goal was to reach 1,500 video visits by the end of 2020. Through communications efforts and quick changes to policies and procedures during the pandemic, they actually had upwards of 45,000 video visits between March and May 2020.

While Children’s of Wisconsin is now operating at 90% of normal volume, Garrity explained that initially, communications directed the community to come in only for emergencies and via telehealth. When it was time to reopen, market research guided their communication tactics. A patient survey indicated that 70 percent of patients had delayed care during the initial weeks of the pandemic, and an additional ten percent say they will delay indefinitely because they do not feel safe.

Humber River Hospital’s Joe Gorman, Director of Corporate and Public Affairs, relayed some similar challenges experienced by the Ontario facility in Canada. “One of the things we decided to do after we shut down the facility’s non-essential services,” Gorman explained, “was to bring in the media. The decision initially caused some controversy, but we wanted to be able to show the community how we were treating COVID-19 and that it’s safe to come in if you need help.”

“Our strategy,” Garrity explained, “was to rely on the doctors and pediatricians who serve our community to be ambassadors for the hospital.”   In addition to acting as spokesmen and women for the hospital, pediatricians also reached out personally to families whose children urgently needed to return to the hospital for care. Humber River Hospital also asked their physicians to work with the media as often as they were needed.

Also on the panel, Todd Aydelotte, a communications expert and Managing Director at Allison and Partners, spoke about the importance of extending communications outward into the community to foster trust. He added that hospital administrators should have faith in their clinicians as ambassadors for their community. “The media piece is not the toughest thing they’ll ever do. We have to have faith in them and understand that they are communicators every day,” Aydelotte concluded.

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Join us for the upcoming webinar series: Making Imaging Intelligently Efficient, including ‘AI and Future of X-ray’. Please register at Innovation.GEHealthcare.com.