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Kjelle E, Berntsen A, Myklebust AM. Reporting radiographers in Norway - A qualitative study on implementation, organisation, and outcomes. Radiography (Lond) 2024; 30:945-950. [PMID: 38657388 DOI: 10.1016/j.radi.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Worldwide, there is an increasing use of imaging services and a shortage of radiologists. One potential solution to this challenge involves introducing task shifting, where radiographers actively contribute to reporting diagnostic images alongside radiologists. This study explored the purpose and value of reporting radiographers in Norway's imaging departments. METHODS This study used a qualitative design with a descriptive approach. Semi-structured interviews were conducted with eleven participants, comprising managers, radiologists, and reporting radiographers, from four hospital trusts in south Norway. The collected data were analysed using inductive content analysis. RESULTS The analysis generated three main categories: "Organisation," "Barriers and facilitators," and "Experienced outcome." The study showed that successfully implementing reporting radiographers required careful planning and preparation due to radiologists' resistance. The radiologists and managers experienced that reporting radiographers contributed to increased service quality and better training of radiographers and resident physicians. Reporting radiographers found the combination of reporting and diagnostic radiography tasks rewarding and challenging simultaneously. CONCLUSION The implementation of reporting radiographers in imaging departments in Norway was described as successful, positively impacting service quality, reporting capacity, and quality development. However, preparation and planning are needed to overcome barriers to task-shifting. IMPLICATIONS FOR PRACTICE This study shows that with management involvement and careful planning, reporting radiographers contribute to a high-quality imaging service.
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Affiliation(s)
- E Kjelle
- University of South-Eastern Norway, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, Post Office Box 235, 3603, Kongsberg, Norway.
| | - A Berntsen
- The Norwegian University of Science and Technology, Institute for the Health Sciences, NTNU Gjøvik, Post Office Box 191, 2802, Gjøvik, Norway.
| | - A M Myklebust
- University of South-Eastern Norway, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, Post Office Box 235, 3603, Kongsberg, Norway.
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Pedersen MRV, Jensen J, Gale N, Senior C, Woznitza N, Heales CJ. Reporting radiographers in Europe survey: Support, role satisfaction, and advanced clinical practice within the European federation of radiographer society (EFRS) member countries. Radiography (Lond) 2024; 30:87-94. [PMID: 37871370 DOI: 10.1016/j.radi.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Increasing number of radiographers are undertaking image reporting throughout Europe. However, there are variations in practice and experience in European countries. The study aim was to investigate reporting radiographer's perceptions in relation to support for their role and workload satisfaction and elements of advanced practice that may also be undertaken. METHODS Following institutional ethical approval an online 34 item questionnaire survey was circulated via social media; Twitter, Facebook, and LinkedIn in a 12-week period in 2022 across Europe. The survey data were managed by the online secure database REDCap (Research Electronic Data Capture). Data was collected across a range of questions, of which those relating to support for, and barriers to radiographer reporting, role and job satisfaction, and other role elements are reported here. RESULTS A response level of 345 individual reporting radiographers replied to the survey from 15 European countries; some questions were optional and therefore had a lower response rate. There was consensus about the need for support from radiologists and management, protected time, and funding to support the reporting role. The majority of respondents received additional pay for taking on this role and expressed satisfaction with their role and workload. In relation to elements of advanced practice, the majority of respondents were involved in educational and managerial activities, and there was interest, but limited involvement, in research. CONCLUSION There was a consensus about the support needed, and perceived barriers to, radiographer reporting, between reporting radiographers from different countries. Whilst there is some commonality in relation to activities such as supervision and education, there was clearer variety in relation to opportunities for research between the respondents, perhaps reflecting the differences between reporting as a standalone role development and reporting as part of an advanced clinical practice role. IMPLICATIONS FOR PRACTICE As there is increasingly an emphasis on advanced clinical practice, reporting radiographers are likely to require support to develop their skills so that they can actively participate in the broader activities associated with this role, including education, leadership, and research.
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Affiliation(s)
- M R V Pedersen
- Department of Radiology, Vejle Hospital - Part of Lillebaelt Hospital, Vejle, Denmark; Department of Radiology, Kolding Hospital- Part of Lillebaelt Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - J Jensen
- Research and Innovation Unit of Radiology, University Hospital of Southern Denmark, Odense, Denmark; Department of Radiology, Odense University Hospital, Odense, Denmark
| | - N Gale
- Medical Imaging, University of Exeter, UK
| | - C Senior
- Dorset County Hospital NHS Foundation Trust, UK
| | - N Woznitza
- University College London Hospitals, UK; Canterbury Christ Church University, UK
| | - C J Heales
- Medical Imaging, Faculty of Health and Life Sciences, University of Exeter, UK
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Lockwood P, Burton C, Woznitza N, Shaw T. Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service within the NHS in England: a systematic literature review. BMC Health Serv Res 2023; 23:1270. [PMID: 37974199 PMCID: PMC10655396 DOI: 10.1186/s12913-023-10161-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England. METHODS Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995-2022 was applied. The literature was assessed against Joanna Briggs Institute's critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers. RESULTS The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership. CONCLUSION The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services.
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Affiliation(s)
- P Lockwood
- Present address: School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, UK.
| | - C Burton
- Present address: School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, UK
| | - N Woznitza
- Present address: School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, UK
- Radiology Department, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, UK
| | - T Shaw
- Present address: School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, UK
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Bradley D, Harrison J, Goodall M, Dobrashian R. Are Advanced Clinical Practitioners perfectly placed to re-report neuroimages to support clinical diagnosis of dementia? INTERNATIONAL JOURNAL FOR ADVANCING PRACTICE 2023; 1:146-150. [PMID: 38229770 PMCID: PMC7615529 DOI: 10.12968/ijap.2023.1.3.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
With the ageing population, the prevalence of dementia is increasing worldwide. There is an emphasis on early, timely diagnosis and treatment options for people with a dementia yet wait times from referral to diagnosis have increased. Neuroimaging performed by radiologists is utilised to support dementia diagnosis and some patients will already have a CT scan from a pre-existing condition such as stroke. The purpose of this commentary is to consider whether ACPs who specialise in dementia, are perfectly placed to re-report on pre-existing neuroimages to support the clinical diagnosis of dementia.
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Affiliation(s)
| | - Joanna Harrison
- Synthesis Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire
| | - Mark Goodall
- Institute of Population Health, University of Liverpool
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Berntsen A, Myklebust AM, Kjelle E. Reporting radiographers in Norway - A qualitative interview study. Radiography (Lond) 2023; 29:450-455. [PMID: 36812792 DOI: 10.1016/j.radi.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION A number of Norwegian radiographers have attended an advanced programme of education and training in musculoskeletal reporting, some in the UK and some in Norway. The aim of this study was to examine how reporting radiographers, radiologists and managers experienced the education, competence, and role of reporting radiographers in Norway. To our knowledge, the role and function of reporting radiographers in Norway has not yet been explored. METHODS The study had a qualitative design and was based on eleven individual interviews of reporting radiographers, radiologists, and managers. The participants represented five different imaging departments from four hospital trusts in Norway. The interviews were analyzed using inductive content analysis. RESULTS The analysis identified two main categories: "Education and training", and "The reporting radiographer". The subcategories were: "Education", "Training", "Competence", and "The new role". The study found the program to be demanding, challenging, and time-consuming. However, the reporting radiographers described it as motivating because they gained new competence. The competence of reporting radiographers was regarded as adequate. The participants found that reporting radiographers had a unique competence in both image acquisition and reporting, and they were described as a missing link between radiographers and radiologists. CONCLUSION Reporting radiographers are experienced as an asset for the department. Reporting radiographers not only contribute to musculoskeletal imaging reports but are also important for collaboration, training, and professional development in imaging, and in collaborating with orthopedics. This was seen to increase the quality of musculoskeletal imaging. IMPLICATIONS FOR PRACTICE Reporting radiographers are a valuable resource in image departments, especially in smaller hospitals where the shortage of radiologists is noticeable.
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Affiliation(s)
- A Berntsen
- Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, NTNU Gjøvik, Postbox 191, 2802 Gjøvik Norway.
| | - A M Myklebust
- Faculty of Health and Social Sciences at the University of South-Eastern Norway (USN) at Drammen, University of South-Eastern Norway (USN), Post Office Box 4, 3199 Borre, Norway.
| | - E Kjelle
- Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, NTNU Gjøvik, Postbox 191, 2802 Gjøvik Norway; Faculty of Health and Social Sciences at the University of South-Eastern Norway (USN) at Drammen, University of South-Eastern Norway (USN), Post Office Box 4, 3199 Borre, Norway.
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Louise McKnight K. Bourdieu's field theory applied to the story of the UK radiography profession: A discussion paper. Radiography (Lond) 2023; 29:90-94. [PMID: 36327520 DOI: 10.1016/j.radi.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES There are many suggestions offered within the literature to decide if a job type is a profession, some using tick box type trait and characteristics analyses to compare the actions and qualities of individuals to a predefined list. However, there is no specific way to resolve what makes or defines a profession. Writers in many disciplines, including radiography, have used these different models, sometimes with conflicting results. This paper explores the use of Bourdieu's replacement of the concept of profession with that of a 'field', meaning a network of occupants with common attributes, in this case radiographers, in an attempt to resolve this issue. FINDINGS In the UK, radiography practitioners and professional bodies generally use the term profession to describe radiography, and this paper explores a defence of the term for radiography. Using Bourdieu's field theory not only helps define a profession, but also explains the difficulties at the boundaries of professions, and the work needed to protect a profession as a credible entity. CONCLUSION This paper supports the argument that radiography is a profession when using Bourdieu's field theory. Radiography continues to work to maintain its status by increasing its symbolic capital by increasing the research output and evidence base of the profession and through role extension. IMPLICATIONS FOR PRACTICE Radiographers can perhaps be assured that radiography is a profession when using Bourdieu's field theory. This paper shows how theoretical frameworks and concepts from outside radiography can be used to support new ways of thinking within the profession.
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Affiliation(s)
- K Louise McKnight
- Department of Radiography, School of Health Sciences, Faculty of Health, Education and Life Sciences, Birmingham City University, Westbourne Rd, Birmingham B15 3TN, United Kingdom.
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Conlon M, Molloy O. Learning to See: Using Mixed OR Methods to Model Radiology Staff Workload and Support Decision Making in CT. SN COMPUTER SCIENCE 2022; 3:361. [PMID: 35818394 PMCID: PMC9255484 DOI: 10.1007/s42979-022-01244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 06/11/2022] [Indexed: 11/30/2022]
Abstract
Demand for Computer Tomography (CT) is growing year on year and the population of Ireland is increasingly aging and ailing. Anecdotally, radiology staff reported increasing levels of workload associated with the patient profile. In this paper, we propose a framework combining discrete event simulation (DES) modeling and soft systems methodologies (SSM) for use in healthcare which captures the staff experience and metrics to evidence workload. The framework was applied in a single-scanner CT department, which completes circa 6000 examinations per year. The scanner case load consists of unscheduled work [inpatient (IP) and emergency department (ED)] and scheduled work [outpatient (OP) and general practitioner (GP)]. The three stage framework is supported by qualitative and quantitative methods and uses DES as a decision support tool. Firstly, workflow mapping and system dynamics are used to conceptualize the problem situation and instigate a preliminary data analysis. Secondly, SSM tools are used to identify components for a DES model and service improvement scenarios. Lastly, the DES model results are used to inform decision-making and identify a satisficing solution. Data from the DES model provided evidence of the differing workload (captured in staff time) for the IP and OP cohorts. For non-contrast examinations, inpatient workload is 2.5 times greater than outpatient. Average IP process delays of 11.9 min were demonstrated compared to less than 1 min for OP. The findings recommend that OP and IP diagnostic imaging be provided separately, for efficiency, workload management and infection control reasons.
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Affiliation(s)
- Mary Conlon
- School of Computer Science, National University of Ireland, Galway, Ireland
| | - Owen Molloy
- School of Computer Science, National University of Ireland, Galway, Ireland
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Learning from the research process: An advanced practitioner reporting radiographer reflective narrative. J Med Imaging Radiat Sci 2022; 53:334-340. [DOI: 10.1016/j.jmir.2022.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/31/2022] [Accepted: 04/13/2022] [Indexed: 11/18/2022]
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Chung S, Mahabir A, Li C, Kim R, Harnett N, Gillan C. Process optimization in breast imaging: Exploring advanced roles for medical radiation technologists. J Med Imaging Radiat Sci 2021; 53:17-27. [PMID: 34922881 DOI: 10.1016/j.jmir.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Medical imaging (MI) is a critical service that underpins the care journey for many who enter the healthcare system. The subspecialty of Breast Imaging (BI) represents a complex and multi-modality MI setting with a well-defined role in the healthcare system. BI holds great potential as a setting to consider opportunities for a medical radiation technologist's (MRT) current role to be modified and leveraged to fulfill novel and advanced roles to optimize patient-centered service. METHODS This study was conducted in three interrelated BI clinics, all at large urban academic hospitals with a common operational infrastructure. It involved three phases; (i) mapping processes and workflows in BI (ii) identification and characterization of care delivery problems (CDPs) within these process maps, and prioritization of opportunities where task shifting might leverage enhanced knowledge, skills, and judgement of MRTs to optimize care. The PEPPA framework - a systematic planning tool for the development and implementation of advanced practice nursing (APN) roles5 - was used, with the first five of nine steps considered in scope for this pilot project. RESULTS Twelve distinct BI processes were identified and mapped as swimlane charts; a single clerical workflow leading up to patient check-in to the BI department, and 11 subsequent clinical processes. Each map included swimlanes for MRTs, radiologists, and clerical staff, as relevant, and included processes ranging from routine mammogram and ultrasound orders to stereotactic-guided core biopsies and rapid diagnostic workflows. Across the maps, 9 CDPs were identified; scheduling, radiologist availability, incorrect orders, and coordination of externally-acquired imaging and consults. The inpatient process map had the most instances of CDP identified, and the radiologist availability CDP was flagged most frequently across processes. Characterization of the root causes of each CDP led to common reflections on team and task factors, including inefficiencies in communication or division of responsibilities, or availability of resources or team members to support workflows. Consultations based on the resultant maps and CDPs led to identification of the following potential advanced roles for MRTs; review and decision-making relating to imaging acquired externally prior to patient appointments, exam ordering and protocoling in defined scenarios, and task-shifting of certain clinical procedures such as breast screening ultrasounds and contrast-enhanced mammography. CONCLUSION Advanced practice for MRTs holds great potential to address system inefficiencies in breast imaging, if approached systematically and with the primary objective to optimize care. Future work will consider trial and evaluation of pilot roles that incorporate advanced opportunities identified in this project.
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Affiliation(s)
- Sheena Chung
- Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto ON
| | - Aruna Mahabir
- Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto ON
| | - Chao Li
- Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto ON; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto ON; Department of Radiation Oncology, University of Toronto, Toronto ON; Department of Medical Imaging, University of Toronto, Toronto ON
| | - Rachel Kim
- Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto ON
| | - Nicole Harnett
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto ON; Department of Radiation Oncology, University of Toronto, Toronto ON
| | - Caitlin Gillan
- Joint Department of Medical Imaging, University Health Network, Sinai Health, Women's College Hospital, Toronto ON; Department of Radiation Oncology, University of Toronto, Toronto ON; Department of Medical Imaging, University of Toronto, Toronto ON.
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Abstract
For this AMEE Guide, we explore the process and application of an evolved tool known as the audio diary. Diaries are a type of qualitative method that has long been advocated for in healthcare education practice and research. However, this tool has been typically underestimated as an approach to capturing how individuals' experiences change over time. In particular, this longitudinal method can nurture a stronger partnership between the researcher and participant, which can empower participants to share their reflections as they make sense of their identities and experiences. There is a wider issue concerning how to use and implement audio diaries in medical education research, this guide outlines a foundational process by which all levels of researchers can use to ensure the purpose, application and use of the audio diary tool is done with quality, rigour and ethics in mind. The processes presented are not a prescriptive approach to utilising audio diaries as a longitudinal method. This AMEE Guide serves as an opportunity for researchers and educators to consult this resource in making decisions to decide whether the audio diary tool is fit for their research and/or educational purpose and how audio diaries can be implemented in health profession education projects. This guide discusses and addresses some of the ethical, operational and contextual considerations that can arise from using audio diaries as a tool for longitudinal data collection, critical reflection, or understanding professionalism.
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Affiliation(s)
- Arun Verma
- The Centre for Medical Education, University of Dundee, Dundee, UK
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Wood K. How is the reporting radiographer role portrayed in published studies? A scoping review. Radiography (Lond) 2021; 28:215-221. [PMID: 34404577 DOI: 10.1016/j.radi.2021.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Radiographers have been undertaking reporting tasks since the 1980's with a wealth of evidence published to support this practice. Radiographers have since developed skills in reporting all body systems, from all referral sources across a range of modalities. Radiographer reporting is now considered established and demand for radiographers in this role is rising to meet service demand. Reporting radiographers work as part of multi-professional image reporting teams, it is unclear how the radiographer role is perceived as part of this model. The aim was to review peer-reviewed literature to evaluate how the role of the reporting radiographer is portrayed and how the relationship between the two imaging professions has developed. KEY FINDINGS Language used to discuss the role of the reporting radiographer has changed over time. There is progress demonstrated from the practice of radiographer reporting being considered contentious or opposed to accepted and established. Recent publications focus on the importance utilising the skills of all multi-disciplinary team members in workforce structure. This features prominently when discussing future workforce design, such as with the Cancer workforce strategy and the development of the national standards for musculoskeletal reporting. CONCLUSION Published literature has highlighted a move towards acceptance of the reporting radiographer role. Multi-disciplinary team working, utilising the skills of all imaging team members, is essential to the success and sustainability of the imaging workforce moving forwards. IMPLICATIONS FOR PRACTICE Reporting by radiographers is established and will be prominent in the reporting workforce as part of long-term workforce planning, considering skills mix to form effective and sustainable multidisciplinary reporting teams.
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Affiliation(s)
- K Wood
- College of Health, Psychology and Social Care, University of Derby, UK.
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Evans C, Poku B, Pearce R, Eldridge J, Hendrick P, Knaggs R, Blake H, Yogeswaran G, McLuskey J, Tomczak P, Thow R, Harris P, Conway J, Collier R. Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review. BMJ Open 2021; 11:e048171. [PMID: 34353799 PMCID: PMC8344309 DOI: 10.1136/bmjopen-2020-048171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK. DESIGN A scoping review was undertaken following JBI methodological guidance. METHODS 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative. RESULTS 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway. CONCLUSION This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.
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Affiliation(s)
- Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Brenda Poku
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruth Pearce
- School of Education, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jeanette Eldridge
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Gowsika Yogeswaran
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - John McLuskey
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Philippa Tomczak
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruaridh Thow
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Harris
- Health Education England East Midlands, Leicester, UK
| | - Joy Conway
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Richard Collier
- Centre for Advancing Practice, Health Education England, Leeds, UK
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Heales CJ, Mills K, Ladd E. Radiographer advanced and consultant practice and community diagnostic hubs - a vision for the future. Radiography (Lond) 2021; 27 Suppl 1:S28-S33. [PMID: 34119400 DOI: 10.1016/j.radi.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This article combines a brief narrative review of the Richards Report with an overview of current radiographer advanced and consultant clinical practice (ACCP) to provide suggestions for future ACCP within radiography. KEY FINDINGS The 'Diagnostics: Recovery and Renewal' report by Professor Sir Mike Richards, published in 2020, has identified a need for improvements to be made to diagnostic services. His recommendations include the introduction of Community Diagnostic Hubs (CDHs) that would provide quicker and easier access to diagnostic tests for patients(1) A narrative review around the concept of Advanced and Consultant Clinical Practice (ACCP) for radiographers demonstrates the capability of the radiographers to expand their role. The article concludes with a vision of how CDHs could potentially provide multiple career pathways for radiographers working at this level of practice. CONCLUSION AND IMPLICATIONS FOR PRACTICE It is acknowledged that some of these concepts are a combination of visionary and aspirational in outlook rather than being entirely based on current practice. The intention of this article, and the implications for practice, are to support on-going discussions to enable radiography, as a profession, to seek ways and opportunities to do things differently whilst ensuring that the patient remains at the centre of the services delivered.
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Affiliation(s)
- C J Heales
- University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, United Kingdom.
| | - K Mills
- University of the West of England, Glenside Campus, Bristol, BS16 1DD, United Kingdom.
| | - E Ladd
- Somerset NHS Foundation Trust, Musgrove Park Hospital, Taunton, Somerset, TA1 5DA, United Kingdom.
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Stevens BJ, Skermer L, Davies J. Radiographers reporting chest X-ray images: Identifying the service enablers and challenges in England, UK. Radiography (Lond) 2021; 27:1006-1013. [PMID: 33875356 DOI: 10.1016/j.radi.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The chest x-ray (CXR) is the most commonly performed x-ray examination in England, UK. Reporting radiographers provide a cost-effective and safe solution for managing CXR backlogs, but not all Trusts support this service development. This study aimed to establish the service enablers and challenges associated with training and employing radiographers to report CXR images in acute hospital sites in England, UK. METHODS Approval for this electronic survey was granted in 84 of 146 (58%) Trusts approached. The survey was open for 10 weeks during August to October 2020, comprising of qualitative and quantitative questions. Data was exported in to an Excel spreadsheet where manual thematic analysis was performed. Descriptive statistics were also generated. RESULTS Sample size was 75 (89% response rate). Thirty-three departments (44%) had at least one trainee. Most departments (n = 53, 71%) employ at least one CXR reporting radiographer. A total of 121/160 (76%) radiographers report CXRs. Number of reporting sessions shows progression. Factors enabling training and employment arise from service improvements, financial pressures, and developing the workforce. The main challenges relate to staffing issues with a number of associated sub-themes. A small faction indicated lack of radiographer interest to report CXRs due to litigation worries; possibly uncovering a new and emerging issue. CONCLUSION Enablers and challenges associated with radiographers reporting CXRs are similar to previous studies. The growth of CXR reporting radiographers and reporting sessions indicates a continuing reliance on radiographers to contributing to managing CXR backlogs. IMPLICATIONS FOR PRACTICE It is recommended that potential trainees are explicitly informed of the legal protection that will be provided, to prevent accountability concerns impacting on the continuing progression in this area of advanced practice.
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Affiliation(s)
- B J Stevens
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall West Midlands, WS2 9PS, UK.
| | - L Skermer
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall West Midlands, WS2 9PS, UK
| | - J Davies
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall West Midlands, WS2 9PS, UK
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Wuni AR, Courtier N, Kelly D. Developing a policy framework to support role extension in diagnostic radiography in Ghana. J Med Imaging Radiat Sci 2020; 52:112-120. [PMID: 33082122 DOI: 10.1016/j.jmir.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A global shortage of radiologists is affecting the timely provision of imaging reports and thus healthcare delivery. This situation has been the main driving factor behind successful role extension by radiographers into areas that traditionally were within the scope of radiologists, including image interpretation and reporting. The shortage of radiologists is even worse in developing countries like Ghana. There is a need for policy to guide the introduction and implementation of role extension in Ghana. METHODS A qualitative, single case study with multiple sites across the country was used. A sample of 16 participants, including 8 radiographers, 3 radiologists, 3 medical officers, a senior official each from the Ministry of Health and the Allied Health Professions Council, were interviewed about role extension. RESULTS The findings indicate the need for a guiding policy of role extension to be spear headed by the Ministry of Health to gain the needed credibility. The findings suggest the policy should be made to meet the local needs of the country. It also established the policy should regulate education and training and the scope of practice. CONCLUSION The study established the need for policy to guide the introduction and practice of role extension in diagnostic radiography in Ghana. The study also established the need for a broad consultation of all key stakeholders based on an internationally accepted consensus building model.
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Affiliation(s)
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, UK
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16
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Woznitza N, Steele R, Groombridge H, Compton E, Gower S, Hussain A, Norman H, O'Brien A, Robertson K. Clinical reporting of radiographs by radiographers: Policy and practice guidance for regional imaging networks. Radiography (Lond) 2020; 27:645-649. [PMID: 32814647 DOI: 10.1016/j.radi.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Radiographer reporting is an essential component of imaging across the United Kingdom. Since the previous policy and practice guidance in 2004 the role and contribution of reporting radiographers has changed significantly. The move to imaging networks further reinforces the need for consistency in scope of practice and clinical governance for radiographer reporting. KEY FINDINGS This guidance provides a consistent, evidence-based template for planning a reporting service, resourcing, clinical governance, preceptorship, volume and frequency of reporting, a peer learning framework and expected standards. CONCLUSION Developed for North Central and East London, this framework and standards will help reduce unwarranted variation. IMPLICATIONS FOR PRACTICE Consistency in practice could help maximise the contribution of radiographer reporting.
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Affiliation(s)
- N Woznitza
- Radiology Department, Homerton University Hospital, UK; School of Allied and Public Health Professions, Canterbury Christ Church University, UK; North Central and East London Cancer Alliance, UK; Health Education England, London, UK.
| | - R Steele
- North Central and East London Cancer Alliance, UK; Radiology Department, University College London Hospitals, UK
| | - H Groombridge
- Radiology Department, University College London Hospitals, UK
| | - E Compton
- Radiology Department, Guys & St Thomas' Hospitals, UK
| | - S Gower
- Radiology Department, Kings College Hospitals, UK
| | - A Hussain
- North Central and East London Cancer Alliance, UK
| | - H Norman
- North Central and East London Cancer Alliance, UK
| | - A O'Brien
- Radiology Department, Kings College Hospitals, UK
| | - K Robertson
- NHS England and Improvement, London, UK; South East London Cancer Alliance, UK
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Wuni AR, Courtier N, Kelly D. Opportunities for radiographer reporting in Ghana and the potential for improved patient care. Radiography (Lond) 2020; 26:e120-e125. [DOI: 10.1016/j.radi.2019.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022]
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Hoddes R, Hattab A, England A. Initial single centre experiences of a radiographer advanced practitioner led nephrostomy exchange programme. Radiography (Lond) 2019; 26:163-166. [PMID: 32052766 DOI: 10.1016/j.radi.2019.11.091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/01/2019] [Accepted: 11/10/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To evaluate the technical success, radiation dose, complications and costs from the introduction of a radiographer-led nephrostomy exchange service. METHODS Post-graduate qualified interventional radiographers with several years' experience in performing other interventional procedures began performing nephrostomy exchanges. Training was provided by an interventional radiologist. Each radiographer performed ten procedures under direct supervision followed by independent practice with remote supervision. Each radiographer was then responsible for the radiological report, discharge, re-referral for further exchange and, where indicated, sending urine samples for culture and sensitivity. Data extraction included the time interval between exchanges, radiation dose/screening time and complications. RESULTS Thirty-eight long-term nephrostomy patients had their histories interrogated back to the time of the initial insertion. The mean (range) age at nephrostomy insertion was 67 (35-93) years and 65% were male. Indications for nephrostomy were prostatic or gynaecological malignancy, ureteric injury, bulky lymphoma and post-transplant ureteric stricture. A total of 170 nephrostomy exchanges were performed with no statistically significant differences in the radiation dose, fluoroscopy time nor complication rates between consultants and radiographers. There was, however, a statistically significant reduction in the time interval between nephrostomy exchanges for the radiographer group (P = 0.022). CONCLUSION Interventional radiographers can provide a safe, technically successful nephrostomy exchange program with radiation doses equivalent to radiologists. This is a cost-effective solution to the capacity issues faced in many departments, whilst providing career progression, job satisfaction and possibly improved care. IMPLICATIONS FOR PRACTICE Radiographer-led interventional services should be considered by other institutions as a means of providing effective nephrostomy exchanges.
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Affiliation(s)
- R Hoddes
- Department of Radiology, Manchester Royal Infirmary, Manchester, UK.
| | - A Hattab
- University of Salford, Salford, UK
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Culpan G, Culpan AM, Docherty P, Denton E. Radiographer reporting: A literature review to support cancer workforce planning in England. Radiography (Lond) 2019; 25:155-163. [DOI: 10.1016/j.radi.2019.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 10/27/2022]
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Snaith B, Clarke R, Coates A, Field L, McGuinness A, Yunis S. How do consultant radiographers contribute to imaging service delivery and leadership? ACTA ACUST UNITED AC 2019. [DOI: 10.12968/bjhc.2019.25.1.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Beverly Snaith
- Clinical Professor of Radiography, Radiology, The Mid Yorkshire Hospitals NHS Trust, Wakefield, England; Faculty of Health Studies, University of Bradford, Bradford, England
| | - Ruth Clarke
- Consultant Radiographer, Radiology, The Mid Yorkshire Hospitals NHS Trust, Wakefield, England
| | - Amanda Coates
- Consultant Radiographer, Radiology, The Mid Yorkshire Hospitals NHS Trust, Wakefield, England
| | - Lisa Field
- Consultant Radiographer, Radiology, The Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, England
| | - Alison McGuinness
- Consultant Radiographer, Radiology, The Mid Yorkshire Hospitals NHS Trust, Wakefield, England
| | - Saminah Yunis
- Consultant Radiographer, Radiology, The Mid Yorkshire Hospitals NHS Trust, Wakefield, England
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Woznitza N, Piper K, Burke S, Bothamley G. Chest X-ray Interpretation by Radiographers Is Not Inferior to Radiologists: A Multireader, Multicase Comparison Using JAFROC (Jack-knife Alternative Free-response Receiver Operating Characteristics) Analysis. Acad Radiol 2018; 25:1556-1563. [PMID: 29724674 DOI: 10.1016/j.acra.2018.03.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/08/2018] [Accepted: 03/29/2018] [Indexed: 12/25/2022]
Abstract
RATIONALE AND OBJECTIVES Chest X-rays (CXR) are one of the most frequently requested imaging examinations and are fundamental to many patient pathways. The aim of this study was to investigate the diagnostic accuracy of CXR interpretation by reporting radiographers (technologists). METHODS A cohort of consultant radiologists (n = 10) and reporting radiographers (technologists; n = 11) interpreted a bank (n = 106) of adult CXRs that contained a range of pathologies. Jack-knife alternate free-response receiver operating characteristic (JAFROC) methodology was used to determine the performance of the observers (JAFROC v4.2). A noninferiority approach was used, with a predefined margin of clinical insignificance of 10% of average consultant radiologist diagnostic accuracy. RESULTS The diagnostic accuracy of the reporting radiographers (figure of merit = 0.828, 95% confidence interval 0.808-0.847) was noninferior to the consultant radiologists (figure of merit = 0.788, 95% confidence interval 0.766-0.811), P < .0001. CONCLUSIONS With appropriate postgraduate education, reporting radiographers are able to interpret CXRs at a level comparable to consultant radiologists.
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Affiliation(s)
- Nick Woznitza
- Radiology Department, Homerton University Hospital, Homerton Row, London E9 6SR, United Kingdom; School of Allied Health Professions, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent CT1 1QU, United Kingdom.
| | - Keith Piper
- School of Allied Health Professions, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent CT1 1QU, United Kingdom
| | - Stephen Burke
- Radiology Department, Homerton University Hospital, Homerton Row, London E9 6SR, United Kingdom
| | - Graham Bothamley
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
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22
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Woznitza N, Steele R, Piper K, Burke S, Rowe S, Bhowmik A, Maughn S, Springett K. Increasing radiology capacity within the lung cancer pathway: centralised work-based support for trainee chest X-ray reporting radiographers. J Med Radiat Sci 2018; 65:200-208. [PMID: 29806102 PMCID: PMC6119729 DOI: 10.1002/jmrs.285] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Diagnostic capacity and time to diagnosis are frequently identified as a barrier to improving cancer patient outcomes. Maximising the contribution of the medical imaging workforce, including reporting radiographers, is one way to improve service delivery. METHODS An efficient and effective centralised model of workplace training support was designed for a cohort of trainee chest X-ray (CXR) reporting radiographers. A comprehensive schedule of tutorials was planned and aligned with the curriculum of a post-graduate certificate in CXR reporting. Trainees were supported via a hub and spoke model (centralised training model), with the majority of education provided by a core group of experienced CXR reporting radiographers. Trainee and departmental feedback on the model was obtained using an online survey. RESULTS Fourteen trainees were recruited from eight National Health Service Trusts across London. Significant efficiencies of scale were possible with centralised support (48 h) compared to traditional workplace support (348 h). Trainee and manager feedback overall was positive. Trainees and managers both reported good trainee support, translation of learning to practice and increased confidence. Logistics, including trainee travel and release, were identified as areas for improvement. CONCLUSION Centralised workplace training support is an effective and efficient method to create sustainable diagnostic capacity and support improvements in the lung cancer pathway.
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Affiliation(s)
- Nick Woznitza
- Radiology DepartmentHomerton University HospitalLondonUK
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| | - Rebecca Steele
- Radiology DepartmentUniversity College London HospitalLondonUK
| | - Keith Piper
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| | - Stephen Burke
- Radiology DepartmentHomerton University HospitalLondonUK
| | - Susan Rowe
- Radiology DepartmentHomerton University HospitalLondonUK
| | - Angshu Bhowmik
- Department of Respiratory MedicineHomerton University HospitalLondonUK
| | - Sue Maughn
- City and Hackney Clinical Commissioning GroupLondonUK
| | - Kate Springett
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
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Woznitza N, Piper K, Burke S, Ellis S, Bothamley G. Agreement between expert thoracic radiologists and the chest radiograph reports provided by consultant radiologists and reporting radiographers in clinical practice: Review of a single clinical site. Radiography (Lond) 2018; 24:234-239. [DOI: 10.1016/j.radi.2018.01.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
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Thom S. Does advanced practice in radiography benefit the healthcare system? A literature review. Radiography (Lond) 2018; 24:84-89. [DOI: 10.1016/j.radi.2017.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/05/2017] [Accepted: 08/07/2017] [Indexed: 10/18/2022]
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25
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Woznitza N, Devaraj A, Janes SM, Duffy SW, Bhowmik A, Rowe S, Piper K, Maughn S, Baldwin DR. Impact of radiographer immediate reporting of chest X-rays from general practice on the lung cancer pathway (radioX): study protocol for a randomised control trial. Trials 2017; 18:521. [PMID: 29110698 PMCID: PMC5674683 DOI: 10.1186/s13063-017-2268-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/23/2017] [Indexed: 11/11/2022] Open
Abstract
Background Diagnostic capacity and suboptimal logistics are consistently identified as barriers to timely diagnosis of cancer, especially lung cancer. Immediate chest X-ray (CXR) reporting for patients referred from general practice is advocated in the National Optimal Lung Cancer Pathway to improve time to diagnosis of lung cancer and to reduce inappropriate urgent respiratory medicine referral for suspected cancer (2WW) referrals. The aim of radioX is to examine the impact of immediate reporting by radiographers of CXRs requested by general practice (GP) on lung cancer patient pathways. Methods A two-way comparative study that will compare the time to diagnosis of lung cancer for patients. Internal comparison will be made between those who receive an immediate radiographer report of a GP CXR compared to standard radiographer GP CXR reporting over a 12-month period. External comparison will be made with a similar, neighbouring hospital trust that does not have radiographer CXR reporting. Primary outcome is the effect on the speed of the lung cancer pathway (diagnosis of cancer or discharge). Secondary outcomes include the effect of the pathway on efficiency including the number of repeat CXRs performed in a timely fashion for suspected infection and the effect of immediate reporting of GP CXRs on patient satisfaction. Discussion The radioX trial will examine the hypothesis that immediate reporting of CXRs referred from GP reduces the time to diagnosis of lung cancer or discharge from the lung cancer pathway. Trial registration International Standard Randomised Controlled Trial Number ISRCTN21818068. Registered on 20 June 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2268-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nick Woznitza
- Radiology Department, Homerton University Hospital, London, UK. .,School of Allied Health Professions, Canterbury Christ Church University, Canterbury, UK.
| | - Anand Devaraj
- Radiology Department, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Samuel M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | | | - Angshu Bhowmik
- Department of Respiratory Medicine, Homerton University Hospital, London, UK
| | - Susan Rowe
- Radiology Department, Homerton University Hospital, London, UK
| | - Keith Piper
- School of Allied Health Professions, Canterbury Christ Church University, Canterbury, UK
| | - Sue Maughn
- City and Hackney Clinical Commissioning Group, London, UK
| | - David R Baldwin
- Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
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Spreading our radiography message. Radiography (Lond) 2017; 23:85. [DOI: 10.1016/j.radi.2017.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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