ECR 2017 / C-1392
Audit of UK Radiology Department communication systems for critical, urgent, and unexpected significant findings.
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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
Conclusion
There is wide variation in practice across the UK with regard to the communication and monitoring of reports with many departments not fully compliant with published UK guidance.
Despite the widespread use of electronic systems,
only a minority of departments have and use electronic tracking to ensure reports have been read and acted upon.
Methods and technologies which departments can put in place to facilitate communication
- Any department intending to upgrade or replace their RIS system should specify the need for fail-safe alerts to be electronically communicated via abnormal flags in HL7 OBX8 to EPR or GP systems.
- Departments not compliant with current guidance should develop and implement protocols,
installing software and procedures as appropriate to their circumstances.
- Within individual departments there should be a clear policy as to what constitutes critical,
urgent and unexpected significant radiological findings.
- All reporting radiology,
radiographic and administrative staff should be clear on the local policy and ensure that they use the local agreed procedures appropriately,
including documenting any required urgent action within the content of the report.
- In addition to abnormal flags sent by fail-safe electronic alert systems,
manual safety-net procedures should also form an important part of the feedback process,
as electronic alerts are currently not entirely reliable.
- Outsourced reports should be subject to the same policies and procedures as local reports.
- Organisations should ensure that their EPR has a read/acknowledgement system,
which allows referrers to create a worklist of all their reports based on referring responsible consultant,
with the ability to filter fail-safe alert reports.
Referrers should have one-click access to full EPR to allow safe acknowledgement of reports in the context of comprehensive clinical information.
Any person accessing reports should do so via their own unique login,
so they are identifiable as the individual who read and,
by implication,
took responsibility for acting on the report.
- Each organisation should ensure that a named individual/individuals within the hospital has/have responsibility for monitoring that all reports are read and that escalation policies are in place for unacknowledged reports.