The current state of radiology report communication in the U.K. poses "unacceptable risks," and this serious ongoing problem has prompted the Royal College of Radiologists (RCR) to release new standards to ensure that urgent findings are communicated and acted upon in a timely manner. Its document can be downloaded from the RCR website for free.
Dr. Richard FitzGerald of the RCR.The RCR report delineates in detail the responsibilities of radiologists, referring physicians, and organizations in the process for producing, communicating, reading, and acting on radiology reports. It also highlights the importance of fail-safe alert systems for imaging studies with critical, urgent, or significant findings.
Only 34% of radiology departments utilize an automated alert system and just 17% have the ability to perform enterprise-wide tracking of radiology reports for referring physicians, according to the RCR.
"As the failure of these [radiology reporting and communication] processes can have profound effects on individual patients' wellbeing, it is essential to develop fail-safe back-up mechanisms to prevent such failures occurring," noted RCR vice president of clinical radiology Dr. Richard FitzGerald in the foreword to the new standards.
The RCR recommends 10 reporting standards:
- All radiological reports should be produced, read, and acted upon in a timely fashion, best to serve the patients' needs.
- It is the responsibility of the radiologist to produce reports as quickly and efficiently as possible, and to flag reports when they feel a fail-safe alert is required.
- It is the responsibility of employing organizations to ensure appropriate reporting and fail-safe systems are in place and to audit regularly.
- It is the responsibility of employing organizations/radiology departments to ensure that reports can be communicated to other information technology (IT) systems using HL7 standards.
- It is the responsibility of the requesting doctor and/or their clinical team to read and act upon the report findings and fail-safe alerts as quickly and efficiently as possible.
- It is the responsibility of employing organizations to provide IT systems whereby, as soon as a verified imaging report has been produced, it is easily available for tracking by clinical teams. All reports should be read and acted upon by the referrer, their team, and/or other relevant clinicians, with a permanent audit trail of who has read the report and who has taken the responsibility for acting upon it.
- Efficient and effective electronic means of fail-safe alert notification require investment by trusts. Until there are robust systems of tracking and notification within electronic patient record (EPR) systems, manual processes via telephone, email, or fax will continue to be required. Patient safety should remain the most important aspect in this process.
- Fail-safe systems should be IT-based to reduce error and increase efficiency, but if facilities are not available, alternative manual processes should be in place.
- If manual processes (for example, telephone calls, emails, faxes, and so on) are required to support the fail-safe process, clerical/administrative staff should be available to support radiologists at all times of the day or night.
- These standards apply to all investigating units, including National Health Service (NHS) hospitals, independent sector services, and teleradiology reporting providers.
Specific responsibilities
The new document (BFCR[16]4) replaces the second edition of the RCR's standards for the communication of critical, urgent, and unexpected significant radiological findings. Further details and delineation of specific responsibilities are provided in the document, which can be found here.
"I commend this updated document to all those who have a responsibility in this area, at an organizational level, in leadership of clinical teams, and in radiological service," FitzGerald wrote. "Individual radiologists should also be aware of its content."
