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Practical ways to make your Ultrasound Lab more efficient

Posted on: 04.27.17

Experiencing a deficit or a surplus of valuable time between procedures is all too common for most ultrasound labs. Both of these factors impact the overall efficiency and profitability of the practice. The problem can be traced back to either the practice or the patient and their role in managing the appointment process.

Communicating the details

Communicating and understanding how in-depth and time-consuming a particular test is are significant factors when ordering studies. It’s critical for physicians and schedulers to communicate specifics about the patient, including what the procedure is and how long it will take. Many times a test is scheduled for a 15-minute slot when the unique situation for that patient will require 45-minutes. One failure to communicate can cause delays for the duration of the day and unnecessary frustration among patients and staff.

Details that should be communicated are whether the patient is ambulatory, not feeling well, in pain, or additional factors that may lengthen the time of the appointment. It’s helpful for the scheduler to have a complete reference list of procedures, a description of what it entails, and the standard time slot needed.

Helping patients improve efficiency

When a patient is scheduled for a procedure, they need to be provided any necessary prep information, in writing, so they’re able to comply on the day of the test. They also need to understand the importance of following the instructions. For instance, if a patient is instructed not to eat or drink at least 4 hours before the procedure and they accidentally drink a cup of coffee, the test will need to be rescheduled. This annoys the patient, wastes valuable lab and technician time, and fills a future appointment that could have been used by another patient.

To avoid no-shows and last-minute cancellations, patients should be called or texted appointment reminders 48 hours before their scheduled appointment. They should have the option to respond directly to the call or text with whether they will keep the appointment or if they need to reschedule.

On the day of the procedure, the office staff should be able to deliver expectations that were previously set. For example, a patient should not sit in a waiting room for two hours when they were led to believe it was going to be a 15-minute wait. That’s not to say that the lab could not be having a bad day. A machine may be unexpectedly in need of repair, or the lab may be short staffed. To alleviate frustrated patients, a good plan of action is to call patients an hour before their test time to let them know the lab is running behind schedule.

Another option is to keep a white board in the waiting room that updates patients on the current time delay so they can use it as a reference point. Even better? Consider a texting system that allows patients to leave the office during a considerable wait period and receive a text message closer to the time they are expected back.

Honest communication increases satisfaction

By effectively communicating with patients, you’re keeping them as happy as possible instead of letting them stew in your waiting room. Nothing runs like clockwork, but these are some things that you can do to increase patient satisfaction and help your practice run more smoothly.

Screening options and recommendations for dense breasts

Posted on: 10.20.16

The topic of breast density is gaining attention lately. To date, 29 states have mandated some level of formal communication to inform women not only of their mammogram results, but also their breast density level. In the battle against breast cancer, there is a growing need and demand for patients to be educated about breast density and their potential need for additional imaging.

What is breast density?

Upon completion of your last mammogram, you may have received a letter informing you that you have dense breasts, and you may be wondering – what does this mean? Breasts are made up of fibrous or glandular tissue and are considered dense when the percentage of fatty tissue is low.

Although women with dense breasts may require additional screening, it is not abnormal. The additional concern is merited because studies have shown that dense breast tissue increases a woman’s risk of developing cancer, and may have some bearing on its reoccurrence. Also, because both dense breast tissue and cancerous cells appear white on a mammogram image, the greater the opportunity is for abnormalities to hide behind the dense tissue and go undetected.

What should I do?

If you’ve had a mammogram and been told that you have dense breasts, your doctor may order additional imaging, typically a screening ultrasound. If the result is inconclusive or your risk level warrants it, he or she may order a molecular breast image (MBI).

An ultrasound uses high-frequency sound waves to create an anatomical view of the breast tissue, which shows exactly how the tissue looks. With the help of a thin layer of gel, a transducer is moved across the breast creating the image, which is based on the reflection of the waves against the body. Ultrasound can be performed with or without the assistance of a dedicated radiologist, depending on the method, and there is no ionizing radiation exposure associated with ultrasound imaging. It’s also relatively inexpensive, by comparison, and the procedure takes approximately 15 minutes plus interpretation time.

MBI uses a radioactive tracer to detect cancer inside the breast. Once the tracer is injected, a nuclear camera takes a physiological image, which captures the interaction of tissue surrounding a cancer as opposed to a snapshot of how it looks. Any abnormal cells will attract a higher concentration of the radioactive substance and identify areas of concern. The MBI procedure typically takes approximately 40 minutes plus interpretation time, and is more expensive than an ultrasound. However, unlike the anatomic images produced by mammography or ultrasound, the physiologic imaging of MBI may offer more conclusive diagnostic confidence.

Take action!

Hearing that you have dense breast tissue may be upsetting, but don’t sit back and accept the uncertainty that comes with it. Take action. By communicating with your physician and discussing your individual need for additional testing, you’ll be doing everything possible to ease your mind. Screening for disease is the key to early detection and being an educated, responsible patient who takes your health seriously will help you live a long and healthy life.

Understanding the differences between Ultrasound or MBI for Breast Imaging

Posted on: 09.22.16

If you were told after your last mammogram that you have dense breast tissue, your doctor may have recommended additional imaging. One of the details included in the mammography report from the radiologist to your doctor is information on how “dense” your breasts are.

Breast density is assigned one of four categories:

  • A – the breasts are mostly fatty
  • B – there are scattered areas of fibroglandular density
  • C – the breasts are heterogeneously dense which may obscure small masses
  • D – the breasts are extremely dense which lowers the sensitivity of mammography

Breast density may increase your risk of developing breast cancer and it can hide small masses making it difficult to diagnose. Often times, breasts that are classified as heterogeneously dense or extremely dense may benefit from additional imaging. Physicians typically opt for an ultrasound or molecular breast imaging to gain a better view and increase their clinical confidence.

Ultrasound vs. MBI

One of the main differences between breast ultrasound and molecular breast imaging is the type of image each produces, either anatomic or physiologic, respectively.

An ultrasound uses high-frequency sound waves to produce an image of the anatomy of the breast tissue at that exact location. With the use of a transducer and a thin layer of gel, the procedure creates a picture that shows the radiologist how the sound waves travel through the density and what the breast tissue looks like.

A molecular breast image produces a physiological image, which demonstrates the interaction of tissue surrounding a breast cancer or any other area of interest in the breast. It shows how the body is performing or reacting. With the help of a radiotracer, the molecular image shows how much of the isotope the tissue is absorbing. Cancerous cells will attract a greater concentration than normal healthy cells, indicating an area of concern.

If you compare these images to a weather map, the anatomical view would be the topographic map where you can see the depth of a mountain range from above, while the physiological picture would be more in line with Doppler radar, where you can see the clouds approaching and the effect they have on the covered area.

Which test is best?

When you consult with your physician, he or she will take into account your individual medical and family history, risk factors, and other health issues before making a recommendation for additional testing.

The ultimate purpose of screening is early detection, but it’s also important for tests to be as quick, accurate, and inexpensive as possible. Mammography is the least expensive method of screening, followed by ultrasound, and then MBI. If your ultrasound results are inconclusive, MBI would most likely be the next step.

MBI has 10+ years of history in the breast imaging world, but it is still considered new technology, which is one reason why appropriate use criteria for the modality is still in the developing stages. Educating yourself and communicating openly with your doctor will help accurately weigh your risk factors and address any concerns so that they can recommend a suitable screening option that meets your specific needs.

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