Patient Info Tool
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This tool was collaboration with input from persons with lived experience of pregnancy and/or pulmonary embolism, and healthcare providers. The information in this tool is based on the guidelines from the Society of Obstetricians and Gynaecologists of Canada.
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Collaborators:
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/ Overview
Key Words: Pulmonary embolism (PE), Patient information tool, Co-design, Pregnancy and imaging, Quality improvement in healthcare
How might we co-design a tool that supports the decision-making process of pregnant patients who need chest imaging to rule out pulmonary embolism? Pregnant individuals are at increased risk of thromboembolic complications, including pulmonary embolism (PE). To rule out PE, chest imaging with computed tomographic pulmonary angiography (CTPA) or nuclear medicine ventilation/perfusion (V/Q) may be required. Both tests utilize ionizing radiation, which have been associated with hesitancy and concerns from the patients who are recommended to be tested by their clinicians. To efficiently counsel patients, clinicians must be comfortable describing exposure to radiation, the benefits and potential harms of both imaging modalities, and be open to any further concerns the patients might have. Unfortunately, certain situations may interfere with the patients’ decision to be tested including suboptimal counselling, miscommunication, inadequate knowledge and erroneous perception of the risks. Moreover, pregnant patients requiring urgent diagnostic testing to rule out PE are often looked after by a wide range of providers, with varying knowledge levels about diagnostic testing in pregnancy, potentially leading to miscommunication and diagnostic delay. A patient information tool specifically designed for pregnant patients requiring urgent imaging to rule out PE may enhance, complement, and standardize counselling by providers and eventually improve the experience of patients undergoing CTPA or V/Q scans in pregnancy. Background Pregnant people are at increased risk of developing pulmonary embolism, which is a dangerous complication of the lungs caused by a blood clot causing blockage in a major vessel in the lungs. Often, these blood clots can cause symptoms that are mild, but in some rare cases it can become severe and life-threatening. For this reason, when pregnant individuals have symptoms that could suggest a blood clot in the lungs, we must be careful and do further imaging tests to confirm if a blood clot is present or not. We most frequently use one of these two tests: a Computed tomography pulmonary angiogram (CT pulmonary angiogram) and a ventilation/perfusion scan. The benefits of accurately diagnosing a blood clot in the lungs during pregnancy largely outweigh any risks associated with these tests, and it is important that patients are well informed when undergoing these tests. |
/ Process
The design process was shaped through ongoing collaborative sessions with pregnant individuals, healthcare providers, and people with lived experience of pulmonary embolism.
Through regular co-design meetings, the tool was refined based on participant feedback. This included ensuring that the language was easy to understand for the general public, the visuals were inclusive and culturally sensitive, and the content helped support clear communication during urgent medical situations. To reflect the two common diagnostic pathways, two separate versions of the tool were developed — one for CT pulmonary angiogram and another for ventilation perfusion (VQ) scan. This ensured that the information provided was specific, accurate, and relevant to the test being recommended. Accessibility was also a core focus. In addition to English and French versions currently in development, the team discussed which other languages might be needed to better support Canada’s diverse population. This iterative approach helped shape a communication tool that is inclusive, understandable, and supportive in moments of stress and uncertainty.
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