Clinical reporting of radiographs by radiographers: Policy and practice guidance for regional imaging networks

Woznitza, N.; Steele, Rebecca; Groombridge, H.; Compton, Emily K.; Gower, Suzanne; Hussain, Ali; Norman, Haskell F.; O'Brien, Anthony Tony; Robertson, Kenneth

doi:10.1016/j.radi.2020.08.004

Cited by 13 publications

(3 citation statements)

References 23 publications

(9 reference statements)

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“…Exploring the enabler data by theme ( gure 3) demonstrated twelve themes with promoting advanced practice 6,13,26,38-41,45-47,49,51- 195,197,[199][200][201][202][205][206][207][208][209]211,213,214,[216][217][218][219][220][221][222][223][224][225][226][227][228][229][231][232][233][234][235][237][238][239][240]242,244,[246][247][248][249][252][253][254][255][256][257][258][259][260][262][263]…”

Section: Resultsmentioning

confidence: 99%

Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: A Systematic literature review

Lockwood

Burton

Woznitza

et al. 2023

Preprint

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Introduction: The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way for healthcare professionals to adopt wider clinical practice roles, resulting in the skills mix development and implementation of diagnostic radiographers' X-ray reporting service in clinical practice. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the implementation of the diagnostic radiographer X-ray reporting service in the National Healthcare System (NHS) in England, which have impacted the implementation and expansion of this advanced practice. Methods: Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository). A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The resulting literature was assessed against Joanna Briggs Institute's critical appraisal checklists. The results were displayed in a PRISMA flow chart and a thematic matrix. Results: The wide and diverse range of data (n=241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership. Conclusion: The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice and behaviours. There has been clear influence upon both meso (professional body organisations) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisational levels. There is clear evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce and radiographer technical skills development. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services and helped improve downstream patient diagnosis, treatment and management outcomes. Implications for practice: The findings of this study can help to inform and support implementation strategies and facilitation of the diagnostic radiographer X-ray reporting service in NHS clinical practice.

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Section: Resultsmentioning

confidence: 99%

Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: A Systematic literature review

Lockwood

Burton

Woznitza

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In this study, lack of training and of time allocated to referral assessment tasks were reported as organisational hindrances for radiographers’ participation. Training and time allocated for referral assessment tasks improve radiographers’ skills and competencies within the justification process [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Radiographers’ actions and challenges when confronted with inappropriate radiology referrals

2022

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Objectives To explore radiographers’ actions toward inappropriate referrals and hindrances to assessing referrals. Methods An online survey was distributed to radiographers via the International Society of Radiographers and Radiological Technologists (ISRRT) networks. The questionnaire consisted of 5-point Likert scale questions on radiographers’ actions to supplement referral information, actions for unjustified referrals and hindrances to referral assessment. The questionnaire was validated using a test–retest reliability analysis. Kappa values ≥ 0.6 were accepted. SPSS software was used for data analysis and chi-square tests to compare subgroups. Results Total responses received were 279. The most reported actions to supplement missing referral information were to ask the patient or relative, examine the body region of concern and check medical records (73%, 70%, 67%, responded often/always, respectively). The actions when confronted with unjustified referrals were reported equally to consult the radiologist, referring clinician and radiographer (69–68% often/always responses). The hindering factors ranked high (agreed/strongly agreed responses) pertained to inadequate information in referral forms (83%), ineffective communication among healthcare professionals (79%), lack of training (70%) and allocated time (61%). Statistically significant associations were observed for a few actions and hindrances with education level, modality of practice and responsibility to screen imaging referrals. Conclusion Radiographers consult colleagues about suspected unjustified referrals. Effective communication pathways, training and time allocation to improve radiographers’ skills to assess referrals may enhance appropriate imaging and delivery of quality patient care. Key Points • Radiographers’ actions of supplementing missing information in radiology referrals facilitate provision of high-quality health services. • Radiographers’ strategy when confronted with inappropriate referrals is to consult radiologists and referring clinicians. • Better inter-professional communication and organisation of tasks can facilitate radiographers’ participation in referral assessment to ensure appropriate imaging. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08470-z.

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“…However, he later identified that radiographers undertaking postgraduate training were assessed to a far larger degree than their radiologist colleagues within the narrow scope of practice in which they were being trained. 41 Such is the emphasis on delivering underpinning knowledge and skills that recent policy and practice guidance for radiographers reporting has been published with the aim of establishing and maintaining standards across imaging networks in England 46 and reducing the risk of misdiagnosis.…”

Section: Limitations To Practicementioning

confidence: 99%

Embedding new technology into clinical ultrasound practice: Is role extension for sonographers the key to improving patient pathways?

Parker

Edwards²,

Twiddy

et al. 2022

Ultrasound

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Introduction: MicroUS is a new imaging technique that may have potential to reliably monitor prostate disease and therefore release capacity in MRI departments. Firstly, however, it is essential to identify which healthcare staff may be suitable to learn to use this modality. Based on previous evidence, UK sonographers may be well placed to harness this resource. Topic: Currently, there is sparse evidence on the performance of MicroUS for monitoring prostate disease but early findings are encouraging. Although its uptake is increasing, it is believed that only two sites in the UK have MicroUS systems and only one of those uses just sonographers to undertake and interpret this new imaging technique. Discussion: UK sonographers have a history of role extension dating back several decades and have proven repeatedly that they are reliable and accurate when measured against a gold standard. We explore the background of UK sonographer role extension and postulate that sonographers are best placed to adopt and embed new imaging techniques and technology into routine clinical practice. This is of particular importance given the dearth of ultrasound focussed radiologists in the UK. To effectively introduce challenging new work streams, multi-professional collaboration in imaging, alongside sonographer role extension, will ensure precious resources are maximised thus ensuring optimum patient care. Conclusion: UK sonographers have repeatedly demonstrated reliability in many areas of role extension in various clinical settings. Early data indicate that the adoption of MicroUS for use in prostate disease surveillance may be another role suited to sonographers.

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Clinical reporting of radiographs by radiographers: Policy and practice guidance for regional imaging networks

Cited by 13 publications

References 23 publications

Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: A Systematic literature review

Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: A Systematic literature review

Radiographers’ actions and challenges when confronted with inappropriate radiology referrals

Embedding new technology into clinical ultrasound practice: Is role extension for sonographers the key to improving patient pathways?

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