Clinical governance is defined as “… a framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.” (Department of Health, 1998). Supervision of radiology reporting services should take place within the clinical governance framework (Paterson et al, 2004).
The National Institute for Clinical Excellence (NICE) and National Service Frameworks (NSFs) have developed guidelines and established performance indicators against which progress can be measured. All NHS organisations have a ...view middle of the document...
There is a lack of national standards related to reporting and local standards need to be established for the production of reports and transfer to referring clinicians (Paterson et al, 2004; and Royal College of Radiologists, 1991).
It is impossible to audit the whole of the radiology reporting service with one audit, it requires several small audits to look at individual areas of the service. In this assignment I have concentrated on the following: reporting accuracy, both radiographer and radiologist; interpretation of the report; reporting time; and volume of reporting; and how they relate to an improvement in the reporting service in terms of accuracy, reduction in unnecessary repeat examinations and quicker response times ensuring a high quality and cost effective service.
RADIOLOGY REPORTING SERVICE
The Royal College of Radiologists (1995; and 1998) state a referral for a radiological examination is a request for an opinion in the form of a written report to assist with the management of the patient. The report provides an integral part of the medical records, is an essential link between diagnosis and treatment, and constitutes the legal record of the imaging investigation (Robinson, 2004; Royal College of Radiologists, 1999; and Stolberg, 2002). It is vital that the information it contains is accurate, timely, informative, explicit and understandable (American College of Radiology, 2001; Paterson et al, 2004; Royal College of Radiologists, 1995 and 1999).
The Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000, states a clinical evaluation of the outcome of each medical exposure must be made. A written report is necessary to ensure compliance with these regulations (House et al, 2003). The rationale for introducing radiographer reporting often includes the need to comply with IR(ME)R 2000 (Paterson et al, 2004).
The Royal College of Radiologists (1995; 1998; and 2002 a) states reporting of radiological images can be delegated to radiographers working within agreed protocols. Extending radiographers roles offers a means of overcoming radiologist shortages quickly, but requires training, support, formal arrangements for delegation and regular audit (Audit Commission, 2002; Paterson et al, 2004; and Royal College of Radiologists, 1995).
Audit of reporting practice is essential to raise awareness of accuracy rates and sources of error, identifying false-positive examinations can prevent further unnecessary investigations (Nightingale, 2004).
Accuracy is defined as the number of true positive (sensitivity) and true negative reports (specificity) divided by all the reports (true positives, true negatives, false positives and false negatives) (Goddard et al, 2001; and Nightingale, 2004).
Due to the possibility of adverse effects of a reporting error, high levels of accuracy are required and are usually in the region of 90-96% for most studies (Brealey, 2001;...