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Chapter 1: Background and nature of the research

1.1 Introduction

The Society and College of Radiographers (SCoR) commissioned this on-line survey to identify the current Information Management and Technology (IM&T) knowledge and skills of the radiography workforce across the spectrum of Clinical Imaging and Radiotherapy. Informants comprised radiographers, academics, educators and radiography managers, primarily employed in the United Kingdom (UK).

The core team undertaking the work was employed by the Department of Radiography at Cardiff University. This team was supported by a larger steering group comprising clinical staff and other experts in IM&T. Membership of the groups can be found in Appendix 1.

1.2 Background

In the last decade the scope of practice for radiographers has rapidly moved forward (SCoR 2003a). The SCoR (2006) recognised radiographers’ dependency on information management and technology to support practice. PACS and digital acquisition technologies for projection radiography have become commonplace in radiotherapy and diagnostic imaging departments across the UK (SCoR IM&T group 2008). Requardt (2006) suggested that the optimisation of healthcare workflow is dependant on the whole chain of events, from diagnosis to treatment. Optimum health care delivery is therefore focused on a service using the latest technology and capable of delivering high quality, patient centred care.

The SCoR (2006) noted the impact of national programmes for the radiography workforce in relation to PACS and record and verification systems, combined with modern planning systems and intensity modulated radiation therapy (IMRT) services. As a consequence of these national programmes whole system changes in healthcare delivery with rapid links across care have taken place and continue to do so. Radiographers are required to utilise information technology at many levels (Society of Radiographers 2006). Government policies, developments in working practices, professional and regulatory requirements and public expectations are likely to increase radiographers’ involvement.

Radiographers are responsible for guaranteeing the integrity of the data that they input into both clinical and administration systems to ensure the delivery and continuity of high quality healthcare for patients and clients (SCoR 2006). There is therefore a need, in addition to basic IM&T skills, as Devvit and Murphy (2003) commented, of more generic skills in health informatics.

The profession of radiography needs to be broad yet flexible in order to satisfy existing and future service needs with provided planned and resourced learning provision (SoR 2003b). Additional support and on-going training will be required if radiographers are to engage with the health informatics agenda and information technology and integrate it fully into daily clinical practice (SCoR 2003b). Furthermore there is a need for radiographers to be trained and educated to an appropriate level to ensure the highest standards of patient care and service delivery (SoR 2003c). Radiographers need to be leaders in developing and maintaining skills and competencies to ensure the technology is appropriately utilised. In addition there is a need for radiographers to be trained and educated to an appropriate level to ensure the highest standards of patient care and service delivery (SoR 2003c).

The SCoR (2006) expects radiographers to engage with, and managers to offer, developmental IM&T opportunities that equip radiographers with the necessary skills. In addition education providers are required to embed IM&T into their curricula and offer appropriate post graduate education.

As a result of the developments there is now a requirement for a comprehensive IM&T skills audit, specific to the radiography profession, in order to establish a baseline of IM&T competency (SCoR 2006). It is anticipated the results of this audit will assist future planning for radiographers IM&T needs. The SCoR (2006) have also set out its expectations for the profession which are:

  • All radiographers will grasp developmental opportunities that will equip them with the necessary IM&T skills;
  • Managers will offer developmental opportunities that ensure all radiography staff are fit for practice, including IM&T fitness;
  • Education providers will embed IM&T within curricular and offer appropriate post qualifying courses to up-skill and maintain competence.

1.3 Aims

The aims of this survey were, therefore, to:

  1. Identify radiographers engagement in clinical systems e.g. radiotherapy planning systems, RIS, PACS; computed verification systems;
  2. Identify radiographers engagement in clinical support systems e.g. audit, governance, research and evidence based practice, electronic requests, prescribing, coding, e-booking;
  3. Identify radiographers’ engagement in general IM&T systems e.g. word processing, email and internet usage.
  4. Determine future IM&T needs and developments;
  5. Identify training needs and standards to be implemented at all levels of the workforce.

1.4 Method

The nature and aims of the study suggested a questionnaire was the most appropriate method of gaining the required information. After consideration of the constraints on resources (time, finance, researchers) and the informants to be targeted it was concluded that an on line questionnaire would keep distribution costs to a minimum while maximising engagement with the radiographic workforce. Additionally the use of the Bristol On-Line Survey (BOS) as an electronic method of data collection facilitated the consideration and analysis of results. A postal questionnaire was made available on request.

In order to avoid any confusion or ambiguity a definition of IM&T was required. After considerable consultation with members of the profession this was agreed as the processes and technology required to capture, store, distribute and analyse patient and service data.

Whilst being mindful of the aims of the study the questionnaire was designed with reference to the literature and current government initiatives in consultation with the project steering group, members of the SCoR IM&T group and clinical and academic colleagues. The diverse nature of radiographers’ involvement in IM&T in and outside the workplace and their engagement with education and training emerged and was embedded into the content of the questionnaire. The questionnaire was divided into seven sections namely: demographic details, IM&T Ability, work based IM&T usage, personal IM&T usage, security & governance issues, education & training experience, and the future.

A pilot questionnaire was considered by approximately 30 informants comprising steering group members, academic and clinical colleagues and members of the IM&T group. Feedback was obtained from 14 of those considering the pilot and subsequent amendments made. A hard copy of the final questionnaire is available in Appendix 2. It was felt that in order for the outcomes to be representative of the radiographic workforce in question widespread engagement was vital. The questionnaire was promoted via articles in Synergy News and on the SCoR web site. The SCoR contacted members individually via e mail and those who were members of SCoR groups, network and regional committees. Flyers were widely distributed and participation encouraged by the opportunity for informants to enter a prize draw to win a digital camera and web cams.

 

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