Proactive Vetting: Reversing the Trend of Rising On-Call Communication Demands

A 12-month digital transformation and culture change programme, re-designing the imaging referral pathway across two sites

Dr A.White 1# , Dr R.Smillie 1# , U. Valli 2 , S. Taylor 3 , Dr C. Roberts 4 , Dr K.Ambalawaner 4 , Dr K. McDonald 4 1Radiology Registrar, 2 Imaging Systems Lead, 3Superintendent Radiographer for PACS, 4Radiology Consultant, #Equal Contribution

 

BACKGROUND

Our centre has a single duty radiology registrar phone line covering two sites; a major trauma centre (Royal London Hospital) and a specialist cardiovascular & cancer centre (St Bartholomew's Hospital).

Problem: extremely high call volumes (Figure 1) created a severe operational bottleneck centred on the inability of the referring teams to get through to the duty radiologist.

Cause: increasing request volumes combined with a legacy non-scalable pathway which mandated a direct telephone conversation between the requesting clinician and Radiologist for every inpatient and emergency department CT and MRI request.

Consequences: delays to urgent and trauma related diagnostics; widespread frustration and formal complaints from referring teams unable to speak to the duty radiologist; documented incivility between referring teams and the duty radiologist; poor quality imaging requests as referring teams defaulted to relaying information verbally given a verbal conversation was mandated; failure to satisfy updated IR(ME)R Employer's Procedures that mandate a robust and traceable electronic system for justifying and placing imaging requests on hold.