Tony Rosen1, Elizabeth M Bloemen2, Jasmin Harpe1,3, Allen M Sanchez4, Kevin W Mennitt4, Thomas J McCarthy1, Refky Nicola5, Kieran Murphy6, Veronica M LoFaso2, Neal Flomenbaum1, Mark S Lachs3. 1. 1 Division of Emergency Medicine, Weill Cornell Medical College, 525 E 68th St, Rm M130, New York, NY 10065. 2. 2 University of Colorado Medical School, Aurora, CO. 3. 3 Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, NY. 4. 4 Department of Radiology, Weill Cornell Medical College, New York, NY. 5. 5 Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY. 6. 6 Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Abstract
OBJECTIVE: Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. SUBJECTS AND METHODS: We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. RESULTS: Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. CONCLUSION: Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.
OBJECTIVE: Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. SUBJECTS AND METHODS: We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. RESULTS: Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. CONCLUSION: Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.
Authors: Tony Rosen; Nisha Mehta-Naik; Alyssa Elman; Mary R Mulcare; Michael E Stern; Sunday Clark; Rahul Sharma; Veronica M LoFaso; Risa Breckman; Mark Lachs; Nancy Needell Journal: Jt Comm J Qual Patient Saf Date: 2018-02-13