Aims and objectives
The move to decoupling of radiologists from modality lists increases the likelihood of poor communication and inadequate educational feedback with follow up studies reported by colleagues,
local or remote. A perception of increasing internal referrals stimulated us to review this trend and associated issues. We also wanted to assess how much ownership we take of cases,
who reports the follow-up study,
and consider the opportunities for educational feedback.
Methods and materials
3000 requests reviewed. 1000 each of USS,CT & MRI We identified the self referrals and then reviewed them in detail.
We looked at: - Ownership in report-Rationale for next study - eg/ diagnostic uncertainty,
disease progression -Referral grade(Substantive/Trainee/Locum/ Radiographer) -Same radiologist reporting both studies? -Evidence of feedback on RIS/PACS (report or addenda)
128 (4.3%) of the 3000 requests were advised by radiologists.
only 14 reported their recommended investigation leaving 114 sources for potential feedback. Unfortunately we could not accurately assess how much,
feedback was given due to absence of any integrated system support for this function. USS – 1000 studies were performed in a 14 day period.
39 were self referred from within the department and only 6 (15%) of these were performed by the referrer. The majority...
Radiologists should be aware of the potential risks with internal referrals and explore ways to secure better patient,
service and personal outcomes. This study confirms that a significant proportion of our work is internally generated. Attention to the potential for poor communication and feedback is,
important if we are to improve personal and service performance and patient outcomes.
Better communication with scanning staff and alterations to operational flows may be of benefit....
Northern Ireland medical and dental training agency,
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Royal college of radiologists; Lifelong learning and building teams using peer feedback;BFCR(17)5; 2017 Rpyal college of radiologists; Continuing professional development (CPD) scheme,
fourth edition; RCR(16)2; 2016