Diagnostic Imaging Pathways - Engagement with Consumers

Information specifically for consumers was initially developed in two phases.


Phase 1 was concerned with a 'Needs Analysis' and was initiated by the Division of Imaging Services at Royal Perth Hospital in collaboration with The Health Consumers' Council of Western Australia in 2005. A project officer was employed. Focus Groups were convened and held at the offices of the Health Consumers' Council. A Consumer Information Reference Group was established to determine the needs and expectations of consumers and their carers. The Focus Groups and the Consumer Information Reference Group included health service representatives from public hospitals in Western Australia (imaging specialists, technologists and nurses), private providers of imaging services, and consumer representatives nominated by The Health Consumers' Council of WA. These groups developed recommendations relating to format and presentation, content, subject and structure.


The TABLE 1 summarises the recommended format and presentation of the information.

TABLE 1: Recommended Format of Information for Consumers

CATEGORY
RECOMMENDED FORMAT AND PRESENTATION

Language and Prose
  • plain English/'everyday' language/familiar words, to be understood by 'most of the people, most of the time'
  • short words
  • short sentences (Max. 15 - 20 words)
  • present/active tense
  • direct not ambiguous, e.g.
    • v DO NOT drink prior to the test
    • X we suggest you do not drink before the test
  • affirmative, e.g.
    • v lie still at all times
    • X you may move unless you are asked to be still
  • use second person/relate it to the person/interactive e.g.
    • v you may feel ill
    • X the patient receiving the test may feel ill


Pictures/Diagrams

  • positive/inclusive images of people of all ages, genders, ethnic and religious groups
  • use to support not confuse written information
  • use flow-charts where possible to demonstrate processes and sequences
  • adequate size
  • ensure correct labeling
  • clear
  • avoid cartoons
  • ensure all logos are readable and explained
  • do not write over a picture/ diagram
  • customize pictures - no 'Clip Art'
  • ensure material is easy to store electronically


Vocabulary

  • no jargon
  • no acronyms (or explain them)
  • no abbreviations
  • consistent; e.g. do not interchange “image” and “x-ray”
  • if clinical/ medical terms unavoidable, explain them
  • numbers one to ten in words, over 10 in digits


Type Face/Fonts

  • serif font types eg: Arial
  • minimal use of capital letters
  • limit number of fonts
  • font 12 pt to 14 pt
  • line spaces font size + 20%
  • bold lower case for emphasis (no italics or underlines)


Layout

  • headings clear
  • small paragraphs of text with spaces in between
  • unjustified or left justified text
  • generous margins
  • use bullet/dot points
  • include Frequently Asked Questions (FAQ's)


Printing Standard

  • 90 gsm paper quality minimum
  • 2-3 colours maximum
  • light background, darker text

TABLE 2 summarises the recommended content of information for consumers.

TABLE 2: Recommended Content of Information for Consumers

CATEGORY
RECOMMENDED CONTENT


Rationale for the examination

  • why a referral has been provided for this examination and not another; possible alternatives
  • what information is expected from this examination; eg will it provide a diagnosis and what will it tell about the condition
  • if the examination is not helpful, what next?


Benefits

  • benefits of having the procedure
  • benefits of not having the procedure
  • benefits of deferring or delaying the procedure for all people or people of high risk; eg pregnancy, pace maker, diabetes


Risks

  • risks of having the procedure
  • risks of not having the procedure
  • risks of deferring or delaying the procedure for all people or people of high risk; eg pregnancy, pace maker, diabetes


Preparation for the examination

  • how soon should the appointment be made
  • should the appointment be booked for a special time and why; eg morning after fasting
  • how to prepare; eg fast/not fast, what to wear, whether to eat/drink anything special and why
  • important information to tell the imaging service providers; eg medications, conditions
  • should someone attend with the patient


Experience of the examination

  • what will happen, step by step
  • how will it feel, sound, taste, look and smell
  • how long it will take
  • possible 'experiences'
  • will the experiences be the same/different to previous imaging examinations
  • will there be a need for an anaesthetic or sedation


After the examination

  • how soon after will walking/driving be possible, and will transport be required
  • possible sensations
  • possible 'experiences'
  • possible side effects, short or long term
  • experiences that would warrant contact with a health professional
  • when the results will be available
  • who will provide the results
  • what may happen if the result is not what was required or expected


Other

  • other sources of relevant information
  • date of creation and last revision of information
  • authors and their credentials

TABLE 3 summarises subjects initially recommended for the development of information for consumers.

TABLE 3: Recommended Subjects of Information for Consumers

RECOMMENDED SUBJECTS


Acute respiratory illness


Chronic Obstructive Pulmonary Disease (COPD)


Musculo-skeletal pain, including:

  • low back pain
  • non-traumatic back pain
  • shoulder pain or instability
  • arthritis


Headache


Cardiovascular conditions, including:

  • reno-vascular hypertension
  • deep vein thrombosis


Cancers, including:

  • prostate
  • bowel
  • stomach
  • lung


Acute and chronic sinusitis


Renal colic, including information about kidney stones


TABLE 4 summarises the recommended structure for information for consumers

TABLE 4: Recommended Structure of Information for Consumers

SECTION
RECOMMENDED STRUCTURE

Title

State problem being investigated and imaging for which referred

Statement Of Purpose

“This information is to help you …………….”

Reasons For Referral

“This imaging referral may tell us ………….”

“You have been referred for this test and not other because …..” (include pathway information if appropriate)

Benefits and Risks Of Imaging

Benefits of having, not having, deferring imaging

Risks of having, not having, deferring imaging

Include reference to high risk groups if appropriate (eg pregnancy, diabetes)

Experience of Imaging

Describe what happens

Describe how it will feel, smell, taste, experience, before, during and after imaging

Preparation for Imaging

Describe what to wear and what not to wear

Describe any special preparation (fasting, ingestion of special materials, etc)

Results

Who will provide the results, when and where

How the images will be provided (digitally or hard-copy)

Who will keep the images and where

Consent

Explain if written consent will be required for the imaging

Side Effects and After Effects

Describe what may happen after imaging, and conditions which require contact with a health-care professional

Further Imaging

Present information on pathways if appropriate

Additional Information

“You can get more information from ………..”

Include reference to relevant Special Interest Groups, Support Groups, etc

Consumer Participation

“This material has been reviewed by health consumers (give examples) ……”

Authors, Qualifications, Affiliations

Sponsorship

Date Created, Date Last Revised

Date of Printing

Feedback

Include a statement encouraging feedback, provide a survey instrument, and describe how to submit feedback


Phase 2 commenced in 2008 with the objective of developing information for consumers based on recommendations that were drafted in Phase 1. The broad aim was to develop information on health topics and imaging examinations identified as a priority, and in a form that ‘most people in the community of Western Australia can understand most of the time’. A project officer was employed and a Consumer Information Review Group was convened which included representatives from the following groups:

  • Aboriginal people
  • People with disabilities
  • Seniors
  • CALD (Culturally and Linguistically Diverse)
  • Division of Imaging Services at Royal Perth Hospital
  • General Practitioners

The project officer drafted information on health topics and imaging examinations that had been identified as a priority and in accordance with the agreed criteria in consultation with the Editor and staff from the Division of Imaging Services at Royal Perth Hospital (imaging specialists, technologists and nurses). The information was then reviewed by the Consumer Information Review Group and Editorial Panel. Input and suggestions were provided to the project officer at meetings and via email. All suggestions were considered and information was re-drafted to ensure that finalised information met the established criteria.


When further topices are identified for development, a Quality Coordinator convenes and engages with a 'virtual' Consumer Information Review Group as summarised in Production Processes. Membership of this group includes imaging specialists, technologists and nurses. Consumer representatives are recruited in consultation with the Health Consumers' Council of WA. The 'Date reviewed:' and the 'Date of next review:' is recorded on the material.


When Diagnostic Imaging Pathways or information about imaging procedures are reviewed as summarised in Production Processes, any corresponding information for consumers is also reviewed and revised according to these processes. The 'Date reviewed:' and the 'Date of next review:' is recorded on the material.


Date reviewed: April 2015

Date of next review: April 2016