COVID-19 Pandemic - considerations and challenges for the management of medical imaging departments in Queensland.

The purpose of this commentary was to outline several key considerations and challenges for medical imaging departments during a global pandemic. Five public hospital medical imaging departments were identified in South-East Queensland, Australia, to provide insight into their response to the COVID-19 pandemic. Common themes were identified, with the four considered most pertinent documented in this commentary. Similar operational considerations and challenges were identified amongst all sites. This commentary intends to serve as a starting point for medical imaging departments in considering the planning and implementation of services in a pandemic scenario.

Communicating traumatic pathology to ensure shared understanding: is there a recipe for the perfect preliminary image evaluation?

Medical imaging and emergency departments work collaboratively to interpret trauma radiographs. In addition to accurate radiographic interpretation, clear communication is crucial to ensure appropriate and timely management of musculoskeletal injuries. This two-step 'how to guide' provides the reviewer with a recipe for effectively evaluating trauma radiographs for traumatic pathology and succinctly documenting the findings. Step 1 is a systematic search of the radiograph: soft tissues, bones, alignment of joints and satisfaction of search (SBASS). Utilising SBASS increases reviewer confidence in identifying traumatic pathology of the appendicular and axial skeleton. Step 2 is a streamlined communication model for the documentation of pathological findings. The WWW acronym (What is it? Where is it? What is it doing?) can be adapted to describe simple or complex traumatic pathology.

Evaluating the effectiveness of intensive versus non-intensive image interpretation education for radiographers: a randomised controlled trial.

INTRODUCTION: The purpose of this randomised controlled trial was to compare the effectiveness of intensive and non-intensive formats of delivery of image interpretation education for radiographers. METHODS: A multi-centre, stratified (by years of experience) two group parallel arm, single blind, randomised controlled trial was conducted. Participants (n = 48) were allocated to one of two groups to receive image interpretation education: (1) intensive format (13.5 h over two consecutive days) (2) non-intensive (sequential 90-min tutorials delivered 1 week apart). Participants undertook x-ray interpretation tests before education, at 1-week post-education completion and at 12-week post-education completion. RESULTS: Image interpretation performance was not significantly different between groups at baseline. A generalised linear model indicated that participants who received intensive education format improved image interpretation performance by a greater margin than the group that received non-intensive education at 1-week (P = 0.002) and 12-week (P < 0.001) follow-up assessments. CONCLUSIONS: Although both formats of education delivery may be beneficial, the findings of this study have indicated that the intensive format of delivery was more effective at improving radiographers' ability to interpret trauma radiographs in the weeks after completion of the image interpretation program.

Evaluating the effectiveness of intensive versus non-intensive image interpretation education for radiographers: a randomised control trial study protocol.

Radiographer commenting systems have not been successfully implemented in many Australian hospitals, despite evidence of their benefit and adoption elsewhere, such as the United Kingdom. An important contributor to the lack of widespread adoption of radiographer commenting in Australia (and likely elsewhere) is the limited availability of accessible education options for radiographers. The purpose of this randomised controlled trial is to compare the effectiveness of the same image interpretation education program delivered over an intensive 2-day period (intensive format) versus a series of shorter regular workshops (non-intensive format). The study design is a multicentre, stratified (by years of experience) two group parallel-arm single-blind (assessor blinded) randomised controlled trial. Participants will be allocated to one of the two groups: (1) intensive format of education or (2) non-intensive format of education in a 1:1 ratio. Participants will undergo assessments before education, at 1 week post-intervention completion and at 12 weeks post-intervention completion. Findings from this trial will be of relevance to radiographers seeking image interpretation training as well as organisations providing image interpretation education to prepare clinical staff for participation in a radiographer commenting system. A limitation of the trial is that the sample will be inclusive of radiographers, and findings may not be able to be directly extrapolated to other clinical disciplines (e.g. junior doctors, physiotherapists or nurse practitioners).

Radiographic imaging for traumatic ankle injuries: a demand profile and investigation of radiological reporting timeframes from an Australian tertiary facility.

BACKGROUND: Radiographic examinations of the ankle are important in the clinical management of ankle injuries in hospital emergency departments. National (Australian) Emergency Access Targets (NEAT) stipulate that 90 percent of presentations should leave the emergency department within 4 hours. For a radiological report to have clinical usefulness and relevance to clinical teams treating patients with ankle injuries in emergency departments, the report would need to be prepared and available to the clinical team within the NEAT 4 hour timeframe; before the patient has left the emergency department. However, little is known about the demand profile of ankle injuries requiring radiographic examination or time until radiological reports are available for this clinical group in Australian public hospital emergency settings. METHODS: This study utilised a prospective cohort of consecutive cases of ankle examinations from patients (n = 437) with suspected traumatic ankle injuries presenting to the emergency department of a tertiary hospital facility. Time stamps from the hospital Picture Archiving and Communication System were used to record the timing of three processing milestones for each patient's radiographic examination; the time of image acquisition, time of a provisional radiological report being made available for viewing by referring clinical teams, and time of final verification of radiological report. RESULTS: Radiological reports and all three time stamps were available for 431 (98.6%) cases and were included in analysis. The total time between image acquisition and final radiological report verification exceeded 4 hours for 404 (92.5%) cases. The peak demand for radiographic examination of ankles was on weekend days, and in the afternoon and evening. The majority of examinations were provisionally reported and verified during weekday daytime shift hours. CONCLUSIONS: Provisional or final radiological reports were frequently not available within 4 hours of image acquisition among this sample. Effective and cost-efficient strategies to improve the support provided to referring clinical teams from medical imaging departments may enhance emergency care interventions for people presenting to emergency departments with ankle injuries; particularly those with imaging findings that may be challenging for junior clinical staff to interpret without a definitive radiological report.