Appropriate medical imaging: Exploring radiographers' assessment of refferals

Abstract

Introduction: A substantial number of radiological examinations are reported to be inappropriate. This is largely due to the fact that a huge number of referral forms received in radiology departments have inadequate patient clinical information to allow effective assessment for appropriate imaging. Inappropriate imaging is a huge global concern for patient safety, radiation protection, effective use of professional labour, and quality health services. Radiographers are identified as a potential professional group that can improve gatekeeping and ensure appropriate imaging through quality checks and assessing referrals due their pivotal position between referring clinicians and radiologists in the radiology referral process. The benefits of using radiographers to assess referrals and their role in ensuring appropriate imaging is, however, not clearly understood.

Aim: The aim of this research is to increase understanding of the radiology referral process, particularly the radiographers’ role in referral assessment, and to discuss how the findings can be understood within the wider theoretical frameworks of peoplecentred health care (PCHC) and professional theory. To achieve this aim, four scientific papers are presented as part of this study.

Conclusion: This research showed that suboptimal referrals are a concern for appropriate imaging and challenge radiology professionals’ adherence to ethical principles of non- maleficence, beneficence, autonomy, and justice, thus impacting on provision of quality care and services in radiology departments. Radiographers’ involvement in assessing referrals improves the justification process and appropriate imaging, supporting the effective principle of PCHC practices to promote patient safety and care. Radiographers’ awareness and use of referral guidelines ensures evidencebased and empathic healthcare. Interprofessional collaboration and communication further promotes teamwork, which is essential for timely treatment, continuity, and coordination of healthcare for patients, and adheres to the PCHC efficiency principle. To enable the radiography profession work force to carry out referral assessment tasks, mapping out essential skills and training is recommended. Radiographers who have gained the necessary training to assess referrals are contributing to the blurring of professional roles and a mixed division of labour, with radiologists thus reshaping the radiographers’ role in referral assessment.