This poster is published under an
open license. Please read the
disclaimer for further details.
Type:
Educational Exhibit
Keywords:
Quality assurance, Technology assessment, Safety, Audit and standards, RIS, PACS, Computer applications
Authors:
K. Drinkwater1, K. A. Duncan2, N. Dugar3, D. Howlett4; 1London/UK, 2Aberdeen/UK, 3Doncaster/UK, 4Eastbourne/UK
DOI:
10.1594/ecr2017/C-1392
Background
It is the responsibility of:
- The radiologist to produce reports as quickly and efficiently as possible.
- The requesting doctor and/or their clinical team to read,
and act upon,
the report findings as quickly as possible.
- The healthcare organisation to provide systems,
whereby as soon as a verified imaging report has been produced,
it is easily available to be read and acted upon by the referrer,
their team and other relevant clinicians.1
Communication failure has been shown to cause patient harm.
Guidance on radiology results communication
The National Patient Safety Agency (NPSA) in 20072 and The Royal College of Radiology (RCR) in 2008 and 20121 published guidance on processes which should be put in place to ensure communication processes are reliable and efficient.
Both the NPSA and the RCR documents emphasise the need for fail-safe back-up mechanisms and safety-net procedures,
and especially so in the case of critical,
urgent,
and unexpected significant findings.
Electronic fail-safe alert technology works by a radiologist creating an alert by clicking a “fail-safe alert tab” on the radiology information system (RIS) or teleradiology platform (picture archiving and communications system [PACS],
voice recognition system [VRS],
teleradiology platform/electronic patient record [EPR]) that is sent out via a global standards HL7 ORU message as an abnormal flag in OBX segment field 8.
A software application such as EPR,
Ordercomms,
standalone application,
or general practitioner (GP) system is then used for reading the report.
Acknowledgement of results is critical for patient safety.
On reading and acknowledging IT applications (whether it be the Hospital EPR or GP system) the consultant or GP must be able to create a worklist of all reports,
and also be able to filter out the fail-safe alert reports,
i.e.,
reports with an abnormal flag so that they can deal with them before the others.
Neither the NPSA nor the RCR guidance indicates what constitutes critical,
urgent,
and unexpected significant findings.
In 2015,
The RCR conducted a clinical audit of all UK radiology departments to establish compliance with this guidance.
The standards being audited were:
- Departments should have a policy in place for radiological imaging reports that require particularly timely and reliable communication; for example,
abnormal,
unexpected,
and/or critical findings.2
- Organisations should ensure service-wide electronic tracking of radiology reports (i.e.
whether radiology results have been read or not).1