Workplace factors facilitating the radiographers' assessment of referrals for diagnostic imaging - A qualitative study.

INTRODUCTION: Radiology referrals are assessed for appropriate imaging based on the available clinical information. The task is legally the responsibility of the radiologists but could be delegated to radiographers under guidance. Knowledge of how this task is organised in radiology departments is limited. The study aim was to identify workplace factors facilitating the radiographers' assessment of referrals for medical imaging. METHODS: Five radiographers were recruited by convenience- and snowball-sampling techniques through the online social media platform LinkedIn. The participants represented different private and public hospitals and had from three to above ten years of experience with assessment of referrals for plain and cross sectional imaging. Following a qualitative approach, 60-min in-depth semi-structured interviews were conducted through online video meetings. Interviews followed a topic guide with 15 questions and 20 keywords, previously tested through a pilot interview. Systematic text condensation was performed using NVivo 12, where central themes and underlying subthemes were developed. RESULTS: Five central facilitating factors were identified, each with subthemes identified as: (1) Formal responsibilities; Documented delegation, Specific role description, (2) Training; Achieving skills, Maintaining skills, (3) Guidelines; Clinical indications, Priority, (4) Resource allocation; Time, Staff, (5) a Supporting environment; Teamwork, Mutual benefits, Feedback and knowledge sharing. CONCLUSION: The study adds new and valuable insights into workplace factors facilitating the radiographers' delegated task of assessing referrals. Workflows adapting such factors benefit radiographers by increasing knowledge and professional development, while positively re-allocating radiologist resources. IMPLICATIONS FOR PRACTICE: The study findings may support radiology workplaces in establishing or improving referral assessment by radiographers. Subsequently, improved quality of patient services may be achieved.

Radiographers' assessment of referrals for CT and MR imaging using a web-based data collection tool.

INTRODUCTION: There is limited research related to the radiographers' role in assessing of radiology referrals to justify imaging. This study investigated radiographers' compliance with guidelines in the assessment of CT and MRI referrals and factors that influenced their performance. METHODS: This research was facilitated by the EFRS Research Hub at ECR 2019. Five radiology referral scenarios for CT and/or MRI were distributed to radiographers, as determined by their scope of practice, who volunteered at the Research Hub. A web-based data collection tool was used. The radiographers were required to determine the appropriateness of each referral, highlight any concerns and recommend suitable investigations if applicable. Linear regression analysis was used to determine whether postgraduate qualification, grade/role of the radiographer and use of guidelines influenced the radiographers' performance in assessing the referrals. RESULTS: Participants originated from 24 countries (n = 51 CT, n = 40 MRI), the majority originating from the UK, Ireland, Italy, Spain, Norway and Austria. Responses consistent with guidelines were 58% and 57% for CT and MRI, respectively. Possession of an MSc qualification in CT was a significant factor of influence for a higher consistency with guidelines (p = 0.02) in CT. Employment as a radiographer in a lead professional role and/or educator was a significant factor of influence for a higher consistency with guidelines in MRI (p = 0.01). CONCLUSION: A total of 58% for CT and 57% for MRI of the radiographers' responses complied with guidelines. Factors such as postgraduate education and leading professional roles are associated with better performance. IMPLICATIONS FOR PRACTICE: Considering qualifications, experience and managerial role is vital before radiographers are delegated task of justifying CT and MR Imaging.