Radiographers’ actions and challenges when confronted with inappropriate radiology referrals

Abstract

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.

Medical imaging consultation practices and challenges at public hospitals in the Amhara regional state, Northwest Ethiopia: a descriptive phenomenological study

“…This implied that when radiologists received detailed information about the patient during the consultation process, they could generate a more credible and trustworthy radiological report that can safeguard the patients from misdiagnosis and treatment. Previous research work confirmed that the acts of radiographers in completing missing data during radiology referrals enhance the provision of high-quality medical services [ 32 ]. However, in some of the referral consultations, radiologists were unable to access the patient to obtain the information they missed because the patient’s family or caregivers were responsible for transporting the image during the consultation process [ 50 , 53 ].…”

“…Findings showed that only 30% of the radiographic images could be correctly interpreted by physicians and students due to a lack of adequate knowledge [ 57 ]. As a solution, enhancing the skills of consulting clinicians working at distant hospitals through short-term training is recommended [ 32 , 57 – 59 ]. To further reduce medical errors, it is advised that quick consultation of medical images in quest of expert judgment is essential [ 60 , 61 ].…”

“…Furthermore, prior studies conducted in the field of radiology [ 9 , 29 – 32 ] paid little attention to answering questions such as: how clinicians consulted the radiological image with radiologists?, what were the available radiology service consultation practices?, what were the challenges that influenced the process of medical imaging consultation?, and what strategies could be developed to address the challenges?). So, gathering data with the help of the aforementioned inquiries could be useful to improve the provision of medical imaging services.…”

Roles and Responsibilities in the Transition to Working Independently: A Qualitative Study of Recently Graduated Radiographers’ Perspectives in Australia

“…The quality of request orders may well impact on the quality of a novice radiographer's work with regard to decisions concerning patient positioning, imaging projections, exposure parameters and dose optimization, which could affect the selection of imaging protocols for patient safety and the accuracy of image interpretation and radiology reports. 24,25 In addition to drawing on prior experience and knowledge through reflection, study participants valued an efficiently and effectively functioning team following the standard care processes needed for sound medical imaging outcomes for patients without compromising staff and patient safety. 24,26 Participants also shared examples that illustrated the importance of coordinating activities, communicating through collaboration, and endeavouring to participate in negotiation and shared decision making.…”

“…24,26 Participants also shared examples that illustrated the importance of coordinating activities, communicating through collaboration, and endeavouring to participate in negotiation and shared decision making. 24,25,27 Interpersonal and professional relations were developed by building rapport and engaging with the team both within the radiography department and beyond. 28 According to Chipere et al, positive interpersonal interactions are the cornerstone of creating a workplace where RGRs feel comfortable about broadening their experience and sense of empowerment.…”