This scenario presents a professional challenge due to the inherent risks associated with contrast media administration, requiring a meticulous and evidence-based approach to patient safety. The critical judgment needed stems from balancing the diagnostic benefits of contrast-enhanced imaging against the potential for adverse reactions, which can range from mild to life-threatening. Adherence to established protocols and continuous vigilance are paramount. The best professional practice involves a comprehensive pre-procedural assessment that includes a detailed patient history focusing on known allergies, previous reactions to contrast media, renal function, and other relevant comorbidities. This assessment should be followed by the administration of contrast media by trained personnel, with immediate availability of emergency resuscitation equipment and appropriate pharmacological interventions for managing adverse events. This approach is correct because it aligns with the fundamental principles of patient safety and the ethical duty of care, as mandated by pan-European guidelines on medical imaging and contrast media safety. These guidelines emphasize proactive risk identification and mitigation through thorough patient screening and preparedness for immediate intervention. An incorrect approach would be to administer contrast media without a thorough review of the patient’s medical history, particularly regarding prior contrast reactions or significant renal impairment. This failure to conduct a proper risk assessment directly contravenes established safety protocols and ethical obligations to protect patients from foreseeable harm. Another incorrect approach is to administer contrast media without ensuring that emergency resuscitation equipment and trained personnel are readily available. This demonstrates a disregard for the potential for acute adverse reactions and a failure to implement necessary safeguards, thereby exposing the patient to undue risk and violating the principle of providing care within a safe environment. Finally, relying solely on the patient’s self-reporting of allergies without independent verification or consideration of other risk factors is also an inadequate approach. While patient history is crucial, it should be supplemented by clinical judgment and, where indicated, objective measures like renal function tests, to ensure a complete risk profile is established. Professionals should employ a systematic decision-making process that begins with a comprehensive patient evaluation, followed by a risk-benefit analysis for contrast administration. This should include a review of institutional protocols, relevant professional guidelines, and consideration of individual patient factors. Preparedness for adverse events, including immediate access to emergency equipment and trained staff, is a non-negotiable component of safe contrast media administration.

Scenario Analysis: This scenario is professionally challenging because it requires a nuanced understanding of the purpose and eligibility criteria for an Advanced Pan-Europe Emergency and Trauma Imaging Quality and Safety Review. Misinterpreting these criteria can lead to inefficient resource allocation, missed opportunities for critical quality improvement, and potential non-compliance with overarching European healthcare quality directives. Careful judgment is required to distinguish between routine quality checks and the specific, advanced nature of this review. Correct Approach Analysis: The best professional practice involves a proactive and targeted approach to identifying facilities that would most benefit from the Advanced Pan-Europe Emergency and Trauma Imaging Quality and Safety Review. This means understanding that the review’s purpose is to elevate the standards of care in high-acuity, time-sensitive imaging environments across Europe. Eligibility should be determined by a facility’s current performance metrics, the complexity of trauma cases handled, and its existing quality management systems, aiming to identify those with the greatest potential for improvement and impact. This aligns with the overarching goal of ensuring consistent, high-quality emergency and trauma imaging services throughout the European region, as mandated by various European Union health directives promoting patient safety and quality of care. Incorrect Approaches Analysis: One incorrect approach involves a passive stance, waiting for facilities to self-report issues or for adverse events to occur before considering the review. This fails to meet the proactive spirit of quality improvement inherent in an advanced review and risks delaying interventions that could prevent harm. It neglects the review’s purpose of identifying areas for enhancement before they become critical problems. Another incorrect approach is to consider the review solely as a punitive measure for underperforming facilities. While identifying areas for improvement is a component, the primary purpose is enhancement and standardization, not solely sanctioning. This mischaracterization can lead to resistance and a lack of collaborative engagement, undermining the review’s effectiveness. A further incorrect approach is to apply the review indiscriminately to all imaging facilities, regardless of their specialization or patient volume in emergency and trauma care. This dilutes the impact of the advanced review, misallocates resources, and fails to address the specific needs of high-acuity trauma centers, which are the intended focus of this specialized quality and safety initiative. Professional Reasoning: Professionals should adopt a framework that prioritizes understanding the strategic objectives of the Advanced Pan-Europe Emergency and Trauma Imaging Quality and Safety Review. This involves clearly defining the review’s purpose – to elevate and standardize high-acuity emergency and trauma imaging services across Europe. Eligibility should then be assessed based on a combination of objective performance indicators, case complexity, and the potential for significant quality enhancement, rather than reactive measures or broad, undifferentiated application. A collaborative and forward-looking perspective is crucial for successful implementation.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate need for diagnostic imaging with the imperative to ensure patient safety and data integrity within a complex, multi-site European healthcare network. The inherent risks involve potential misdiagnosis due to image quality issues, radiation overexposure, and breaches in data security or patient confidentiality across different national regulatory landscapes. Careful judgment is required to implement a robust risk assessment that is both effective and compliant with diverse European Union directives and national implementations concerning medical device quality, data protection, and patient safety. Correct Approach Analysis: The best professional practice involves a systematic, multi-disciplinary risk assessment that prioritizes patient safety and diagnostic accuracy by establishing clear, measurable quality benchmarks for imaging equipment and protocols across all participating sites. This approach necessitates proactive identification of potential failure modes in imaging equipment, image acquisition, and data transmission, followed by the implementation of preventative and mitigating controls. Regulatory justification stems from the EU Medical Device Regulation (MDR) which mandates robust risk management throughout the lifecycle of medical devices, including their use in clinical practice. Furthermore, it aligns with the principles of patient safety and quality of care expected under various European health directives and national healthcare standards, emphasizing the need for consistent, high-quality diagnostic services regardless of location. Incorrect Approaches Analysis: One incorrect approach involves relying solely on retrospective incident reporting to identify and address imaging quality issues. This is a reactive strategy that fails to meet the proactive requirements of risk management mandated by the MDR. It risks significant patient harm and diagnostic errors occurring before they are identified, and does not adequately address the potential for systemic failures across multiple sites. Another incorrect approach is to delegate the entire responsibility for imaging quality assurance to individual site IT departments without a centralized oversight mechanism. This fragmented approach can lead to inconsistent standards, lack of interoperability, and failure to address cross-site risks effectively. It neglects the need for a unified risk management strategy that considers the entire network’s performance and compliance with overarching EU and national regulations. A further incorrect approach is to focus exclusively on the technical specifications of imaging equipment without considering the human factors and procedural elements involved in image acquisition and interpretation. This overlooks critical risks related to operator training, protocol adherence, and workflow efficiency, all of which significantly impact image quality and patient safety. Such a narrow focus fails to encompass the holistic risk assessment required by regulatory frameworks. Professional Reasoning: Professionals should adopt a structured, proactive risk management framework. This involves forming a multidisciplinary team (including radiologists, physicists, IT specialists, and quality managers) to conduct a thorough hazard identification and risk analysis for all aspects of the imaging pathway. This analysis should inform the development of clear quality indicators, standardized protocols, and regular audits. Continuous monitoring and feedback loops are essential to adapt to evolving risks and ensure ongoing compliance with relevant EU and national regulations, prioritizing patient well-being and diagnostic integrity.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for consistent quality and safety in emergency and trauma imaging across a pan-European network with the practicalities of performance review, scoring, and the potential impact on individual practitioners and departments. The inherent variability in patient presentations, equipment, and local protocols necessitates a robust yet adaptable framework. The risk assessment approach is crucial to identify areas where deviations from quality standards pose the greatest threat to patient outcomes, thereby prioritizing review efforts and resource allocation. Correct Approach Analysis: The best professional practice involves a risk-assessed blueprint weighting and scoring system that prioritizes critical imaging quality and safety indicators directly linked to patient outcomes in emergency and trauma settings. This approach ensures that the most significant potential harms are identified and addressed first. Retake policies should be clearly defined, fair, and focused on remediation and continuous improvement rather than solely punitive measures. This aligns with the overarching ethical duty to provide high-quality patient care and the regulatory imperative to maintain and improve imaging standards, as often stipulated by national health authorities and professional bodies across Europe that emphasize patient safety and evidence-based practice. The weighting reflects the potential impact of each criterion on patient safety and diagnostic accuracy in time-sensitive situations. Incorrect Approaches Analysis: One incorrect approach would be to apply a uniform weighting and scoring system across all imaging quality and safety indicators without considering their differential impact on emergency and trauma patient outcomes. This fails to acknowledge that certain deviations, such as incorrect patient positioning in a critical trauma scan, carry a far higher risk than minor variations in image contrast that do not impede diagnosis. Such a system would misallocate review resources and potentially overlook critical safety issues. Retake policies in this context, if overly punitive and lacking a clear pathway for improvement, could discourage reporting and hinder learning. Another incorrect approach would be to implement a scoring system that heavily favors subjective or less critical technical parameters while downplaying objective, patient-outcome-related metrics. For instance, prioritizing aesthetic image quality over the accurate identification of a life-threatening injury would be a significant failure. This approach neglects the core purpose of quality and safety reviews in emergency and trauma imaging, which is to ensure timely and accurate diagnosis for immediate patient management. Retake policies that are arbitrary or inconsistently applied would further undermine the credibility and effectiveness of the review process. A third incorrect approach would be to have vague or non-existent retake policies, or policies that are overly lenient and do not enforce necessary improvements. This would allow substandard practices to persist, potentially leading to diagnostic errors or delays in treatment, directly contravening the principles of patient safety and quality assurance mandated by European healthcare regulations and professional standards. Without clear consequences and a structured process for re-evaluation, the review system loses its efficacy in driving positive change. Professional Reasoning: Professionals should adopt a decision-making process that begins with understanding the specific context of emergency and trauma imaging. This involves identifying the critical quality and safety indicators that have the most direct impact on patient outcomes in these high-stakes environments. A risk assessment framework should then be used to weight these indicators appropriately within the blueprint and scoring system. Retake policies should be developed collaboratively, ensuring they are transparent, fair, and focused on learning and improvement, with clear escalation pathways for persistent issues. Regular review and adaptation of the weighting, scoring, and retake policies based on performance data and evolving best practices are essential for maintaining a robust and effective quality and safety program.

The assessment process reveals a critical juncture in maintaining high standards for emergency and trauma imaging across European healthcare institutions. This scenario is professionally challenging because it requires balancing the immediate need for efficient data management and reporting with the imperative of adhering to stringent, evolving European Union (EU) regulations concerning data privacy, security, and the quality of medical imaging. The integration of informatics systems must not compromise patient safety, data integrity, or regulatory compliance, demanding careful ethical and legal consideration. The best approach involves a proactive and comprehensive strategy that prioritizes regulatory compliance and patient safety through robust informatics integration. This entails establishing clear protocols for data handling, anonymization, and secure transmission that are fully aligned with the General Data Protection Regulation (GDPR) and relevant EU directives on medical device cybersecurity and quality standards. It requires ongoing training for staff on these protocols and regular audits to ensure adherence. Furthermore, it necessitates a system that allows for seamless, secure data sharing for quality review purposes while strictly controlling access and maintaining audit trails, thereby fulfilling the ethical obligation to protect patient confidentiality and the legal requirement for data protection. An approach that prioritizes immediate reporting efficiency by bypassing certain data anonymization steps for internal review, assuming internal staff are bound by confidentiality, is ethically and regulatorily flawed. While internal review is crucial, the GDPR mandates specific protections for personal data, and bypassing anonymization, even internally, creates an unnecessary risk of data breach and violates the principle of data minimization. This approach fails to uphold the stringent requirements for data processing and protection. Another unacceptable approach is to delay the integration of informatics systems due to perceived complexity or cost, opting instead for manual data compilation for quality reviews. This is problematic because it significantly increases the risk of human error, delays critical feedback loops for quality improvement, and can lead to non-compliance with EU regulations that increasingly expect digital and integrated systems for efficient and safe healthcare delivery. It also fails to leverage the benefits of informatics for enhanced patient care and operational efficiency. Finally, an approach that focuses solely on the technical aspects of data transfer without adequately addressing the legal and ethical implications of data privacy and security is insufficient. While technical functionality is important, it is secondary to ensuring that data handling practices are compliant with GDPR and other relevant EU legislation. This oversight can lead to severe penalties and damage to patient trust. Professionals should employ a decision-making framework that begins with a thorough understanding of all applicable EU regulations, including GDPR, and any specific national implementations. This should be followed by a risk assessment of proposed informatics solutions, focusing on potential breaches of data privacy, security vulnerabilities, and impacts on imaging quality. The chosen solution must then be evaluated against its ability to meet both technical requirements and regulatory obligations, with a strong emphasis on patient confidentiality and data integrity. Continuous monitoring and adaptation to evolving regulatory landscapes are also essential components of responsible informatics integration in healthcare.

Scenario Analysis: This scenario presents a professional challenge because it requires balancing the imperative for high-quality, safe patient care with the practical constraints of limited resources and time. The candidate’s preparation for an advanced review of imaging quality and safety in a pan-European context demands a structured and informed approach. Failure to adequately prepare can lead to suboptimal performance, potentially impacting patient safety and the credibility of the review process. Careful judgment is required to select preparation methods that are both effective and efficient, aligning with the advanced nature of the subject matter and the diverse regulatory landscape implied by “Pan-Europe.” Correct Approach Analysis: The best professional practice involves a multi-faceted preparation strategy that prioritizes understanding the core principles of imaging quality and safety, familiarizing oneself with relevant European guidelines and best practices, and engaging with current research and case studies. This approach acknowledges that “Pan-Europe” implies a need to understand commonalities and potential variations in regulatory frameworks and clinical standards across different European countries, even if specific regulations are not detailed in the prompt. It emphasizes proactive learning, critical analysis of information, and the development of a robust knowledge base. This is correct because it directly addresses the advanced nature of the review, ensuring the candidate is equipped to critically assess and contribute to quality and safety discussions across a broad geographical context. It aligns with the ethical obligation to maintain professional competence and contribute to patient safety through informed practice. Incorrect Approaches Analysis: One incorrect approach involves solely relying on a brief overview of general imaging principles without delving into specific European quality and safety standards or current advancements. This fails to meet the “advanced” requirement of the review and neglects the pan-European scope, potentially leading to a superficial understanding that cannot address the nuances of quality and safety across different healthcare systems. It is ethically deficient as it does not demonstrate a commitment to thorough preparation for a role that impacts patient care. Another incorrect approach is to focus exclusively on preparing for a single country’s specific regulations, assuming they are universally applicable across Europe. This is a significant regulatory and ethical failure. The prompt specifies “Pan-Europe,” indicating a need for broader awareness. Relying on a single jurisdiction’s framework ignores the diversity of European healthcare systems and their respective regulatory nuances, leading to an incomplete and potentially inaccurate assessment during the review. A further incorrect approach is to postpone preparation until immediately before the review, hoping to “cram” information. This demonstrates a lack of professional diligence and respect for the importance of the review. Advanced topics require sustained learning and assimilation, not last-minute memorization. This approach is ethically problematic as it suggests a lack of commitment to the critical task of ensuring imaging quality and safety, which directly impacts patient well-being. Professional Reasoning: Professionals facing similar preparation challenges should adopt a systematic approach. First, they should clearly define the scope and objectives of the review, considering the implied geographical and thematic breadth. Second, they should identify key knowledge domains and relevant resources, prioritizing authoritative sources such as professional body guidelines, peer-reviewed literature, and reputable educational materials. Third, they should allocate sufficient time for learning, reflection, and application, creating a realistic study schedule. Finally, they should engage in self-assessment to identify knowledge gaps and seek clarification or further study as needed, ensuring a comprehensive and confident approach to their professional responsibilities.

Scenario Analysis: This scenario presents a professional challenge stemming from the inherent tension between the need for rapid diagnostic imaging in emergency situations and the ethical imperative to ensure patient safety and data integrity. The clinician must balance the urgency of the patient’s condition with the responsibility to select imaging protocols that are both clinically appropriate and adhere to established quality and safety standards, avoiding unnecessary radiation exposure or suboptimal image acquisition that could lead to misdiagnosis or delayed treatment. Careful judgment is required to navigate potential conflicts between immediate patient needs and long-term quality assurance. Correct Approach Analysis: The best professional practice involves a systematic review of the patient’s clinical presentation and the specific diagnostic question being asked, cross-referencing this with established, evidence-based imaging protocols for emergency and trauma scenarios. This approach prioritizes patient safety by ensuring that the chosen protocol is the most appropriate for the clinical question, thereby minimizing radiation dose while maximizing diagnostic yield. It aligns with the principles of good clinical practice and the ethical duty to provide competent and safe patient care, as mandated by professional bodies and regulatory guidelines that emphasize evidence-based decision-making and patient-centered care. This ensures that the imaging serves its intended purpose effectively and efficiently. Incorrect Approaches Analysis: Opting for a standardized, “one-size-fits-all” protocol without considering the specific clinical question, even if it’s a commonly used emergency protocol, risks suboptimal imaging. This could lead to the need for repeat scans, increasing radiation exposure and delaying diagnosis, which is ethically problematic and potentially violates principles of radiation protection. Similarly, prioritizing speed of acquisition over protocol appropriateness, perhaps by selecting a protocol known for its rapid execution but not necessarily its diagnostic accuracy for the specific injury, compromises patient care and safety. This disregards the fundamental purpose of imaging, which is to provide accurate diagnostic information. Relying solely on the radiographer’s experience without direct clinical input or protocol validation, while valuable, can lead to deviations from best practices if the radiographer’s experience does not encompass the full spectrum of potential clinical nuances or the latest evidence-based guidelines. This approach can introduce variability and potential errors in protocol selection. Professional Reasoning: Professionals should adopt a structured decision-making process that begins with a thorough understanding of the clinical context and the precise diagnostic question. This should be followed by an informed selection of imaging protocols, drawing upon evidence-based guidelines and institutional protocols. Regular review and optimization of these protocols, based on outcomes and evolving best practices, are crucial. Collaboration between referring clinicians, radiologists, and radiographers is essential to ensure that protocol selection is always aligned with the patient’s best interests and the highest standards of imaging quality and safety.

The risk matrix shows a moderate probability of a significant adverse event related to radiation exposure during a new pan-European trauma imaging protocol implementation. This scenario is professionally challenging because it requires balancing the imperative to adopt potentially life-saving advanced imaging techniques with the absolute ethical and regulatory obligation to ensure patient and staff safety from ionizing radiation. The rapid pace of technological advancement in medical imaging, coupled with the diverse regulatory landscapes across European nations, necessitates a robust and harmonized approach to quality assurance. Careful judgment is required to avoid both under-regulation, which could lead to harm, and over-regulation, which could stifle innovation and access to care. The best approach involves a proactive, multi-disciplinary quality assurance program that integrates radiation physics principles, instrumentation verification, and ongoing safety monitoring, aligned with the European Union’s Basic Safety Standards Directive (Council Directive 2013/59/EURATOM). This includes establishing clear protocols for equipment calibration and performance testing by qualified medical physicists, implementing dose monitoring and auditing systems, and ensuring comprehensive training for all staff involved in the imaging chain. This approach directly addresses the identified risk by systematically mitigating potential sources of error and exposure, thereby upholding the ALARA (As Low As Reasonably Achievable) principle and ensuring compliance with legal requirements for radiation protection. An approach that prioritizes immediate protocol implementation without prior rigorous equipment validation and staff training would be professionally unacceptable. This failure would contravene the fundamental principles of radiation safety and regulatory mandates that require demonstrable safety and efficacy before widespread adoption of new procedures. It risks exposing patients and staff to unnecessary radiation due to unverified equipment performance or inadequate understanding of optimal imaging parameters, leading to potential deterministic and stochastic effects. Another unacceptable approach would be to rely solely on manufacturer-provided specifications for instrumentation without independent verification and ongoing quality control. While manufacturer data is a starting point, regulatory frameworks and best practices mandate independent assurance that equipment performs as intended under real-world clinical conditions and that its output is consistent and safe. Ignoring this step could lead to subtle but significant deviations in radiation dose and image quality, undermining patient care and safety. Finally, an approach that delegates all quality assurance responsibilities to the clinical imaging staff without the involvement of specialized medical physics expertise would be insufficient. While clinical staff are crucial, the complex interplay of radiation physics, instrumentation, and dose optimization requires the specialized knowledge and skills of medical physicists to ensure comprehensive and effective quality assurance, as stipulated by radiation protection legislation. Professionals should employ a systematic decision-making framework that begins with a thorough risk assessment, followed by the development of a comprehensive quality assurance plan that incorporates regulatory requirements, expert input (including medical physics), and continuous monitoring and improvement. This framework ensures that patient and staff safety are paramount while enabling the effective and ethical use of advanced imaging technologies.

This scenario presents a professional challenge due to the inherent tension between the rapid advancement of imaging technology, the potential for improved patient outcomes, and the ethical imperative to ensure equitable access to care and avoid unnecessary resource utilization. The pressure to adopt new modalities, driven by both technological innovation and competitive pressures, can conflict with the need for rigorous evidence-based validation and the financial realities of healthcare systems. Careful judgment is required to balance these competing interests. The best professional approach involves a systematic, evidence-based evaluation of new advanced modalities. This includes critically reviewing peer-reviewed literature, consulting with multidisciplinary teams, and considering the specific clinical needs and patient populations within the institution. Prioritizing modalities with demonstrated superior diagnostic accuracy, improved patient management, or significant cost-effectiveness for specific indications, while ensuring adequate training and quality control, aligns with the principles of responsible innovation and patient-centered care. This approach is ethically sound as it seeks to maximize patient benefit while minimizing waste and ensuring that resources are allocated judiciously. It also adheres to the spirit of continuous quality improvement and evidence-based practice prevalent in European healthcare guidelines. An approach that prioritizes the immediate adoption of any new advanced modality solely based on its availability or perceived prestige, without a thorough assessment of its clinical utility, cost-effectiveness, or potential for harm, is professionally unacceptable. This could lead to the misallocation of resources, exposing patients to unnecessary radiation or contrast agents without clear benefit, and potentially diverting funds from established, effective treatments. Ethically, this fails the principle of non-maleficence and beneficence. Another professionally unacceptable approach is to delay the adoption of demonstrably beneficial advanced modalities due to institutional inertia or a reluctance to invest in necessary training and infrastructure. This can result in patients not receiving the best possible diagnostic information or treatment planning, potentially leading to suboptimal outcomes. It also fails to uphold the professional responsibility to provide the highest standard of care. Finally, an approach that focuses solely on the technical capabilities of a modality without considering its integration into existing clinical workflows and the potential impact on patient experience and staff workload is also flawed. This can lead to inefficient use of the technology and may not translate into tangible improvements in patient care. Professionals should employ a decision-making framework that involves: 1) identifying a clinical need or question that advanced imaging might address; 2) conducting a comprehensive literature review to assess the evidence for the modality’s efficacy and safety; 3) engaging in multidisciplinary consultation to gather diverse perspectives; 4) performing a cost-benefit analysis, considering both financial implications and patient outcomes; 5) developing clear protocols for implementation, quality assurance, and staff training; and 6) establishing mechanisms for ongoing evaluation of the modality’s impact.

The investigation demonstrates a scenario where a radiographer, while reviewing images of a critically ill patient in the emergency department, notices a subtle but potentially significant finding that was not immediately apparent to the reporting radiologist. This situation is professionally challenging because it pits the radiographer’s direct observation and evolving understanding of patient care against the established reporting hierarchy and the potential for overstepping professional boundaries. The need for careful judgment arises from balancing the imperative to advocate for patient safety with the established roles and responsibilities within the multidisciplinary team. The best professional approach involves discreetly and respectfully bringing the observation to the attention of the reporting radiologist or the attending clinician, providing specific details of the finding and its potential implications. This approach is correct because it upholds the radiographer’s ethical duty to patient welfare and safety, as mandated by professional codes of conduct and quality assurance guidelines prevalent in European healthcare systems. It respects the established reporting structure while ensuring that critical information is not overlooked. This aligns with principles of good clinical practice, emphasizing open communication and collaborative decision-making to achieve the best patient outcomes. An incorrect approach would be to directly alter the radiology report without consultation, as this bypasses the established diagnostic process and the expertise of the reporting radiologist, potentially leading to misinterpretation or the introduction of errors. This violates professional accountability and the integrity of the reporting system. Another incorrect approach would be to ignore the finding due to uncertainty or fear of reprisal. This fails to meet the ethical obligation to act in the patient’s best interest and could have serious consequences if the finding is indeed critical. Finally, discussing the finding extensively with other colleagues without first informing the reporting radiologist or attending clinician could lead to premature or inaccurate conclusions and potentially breach patient confidentiality if not handled appropriately within the clinical team. Professionals should employ a decision-making framework that prioritizes patient safety, respects professional roles, and promotes clear, timely, and respectful communication. This involves a systematic evaluation of the observation, consideration of its potential impact on patient care, and a proactive, collaborative approach to addressing any concerns with the appropriate members of the healthcare team.