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Designing a radiographer reporting service to cope with pressures of Covid-19

11 May, 2020

Author: Nicholas Barlow, Consultant Radiographer in Plain Film, Rotherham NHS Foundation Trust

The team at Rotherham l to r: Lisa Hickling, professional lead; Melanie Dobson and Sophie House, advanced practitioner radiographers; Rachel Bell, interim deputy professional lead; Robert Milner and Nick Barlow, consultant radiographers.

With the onus on efficient reporting of Covid-19 cases, some trusts have delegated all chest reporting to radiologists, despite having established chest reporting radiographers in place.

At Rotherham we wanted to ensure the reporting radiographer team continued to deliver the service. The consultant radiographers worked closely with the clinical lead radiologist to standardise report format and provide a clear summary of the findings in relation to Covid-19 ‘atypical’, ‘indeterminate’, and ‘highly suspicious’.

There have been no concerns regarding reporting quality whilst the team has provided this service.

Before the pandemic

In recent years, the radiographer reporting team at Rotherham was significantly re-structured to respond to increased service demands and ambitious local report turnaround times (TaTs).

A reporting team comprising two consultant radiographers, two advanced practitioners, and one trainee, was established.

Accuracy is evidenced through a robust per review system. From January to March 2020 for example, a team accuracy of 99.3% was achieved on a background of 7.94% of total workload audited.

This reassures radiologists that the service is safe and effective and, consequently, plain film reporting has largely been delegated. In 2019 the radiographers reported 82.5% of all plain films in the trust, including 98.9% of all GP examinations.

How Covid-19 has changed the service

The reporting team has adapted to provide 7-day reporting from 8am-6pm. This service was created in conjunction with the professional lead and is provided with a combination of both in-house and home reporting. Members of the team are contactable either by phone or email at home.

The team has maintained efficient report TaTs with an average of 0.7 day turnaround across all referral sources.

During these times, it is imperative that both reporting and clinical teams are united in their efforts and provide each other with both technical and emotional support.

The teams work closely with each other to provide guidance and support with referral justification and image quality. The clinical team will raise any suspicious findings immediately to ensure efficient reporting.

One of the consultant radiographers attends the on-site morning meetings which updates everyone on changes to protocol and keeps the reporting team informed about developments on the shop floor.

We are also in the process of re-training to work in the department and carry out portable examinations on the Covid wards. This will allow us to share our expert knowledge with staff in the department and underlines that 'we are all in this together'. Several members of the clinical team have said they appreciate the gesture.

What's next?

In spite of the challenges to staffing and workload the pandemic has brought, we are still trying to develop the service and expand the team.

We are continuing to support our trainee reporting radiographer in musculoskeletal reporting with in-house teaching and report auditing.

One of the consultant radiographers is learning to report both paediatric/neonatal chest and abdomen, as well as specialist paediatric musculoskeletal examinations, to increase the team’s reporting scope of practice still further.

We also intend to enroll both advanced practitioners on a postgraduate leadership module in October to provide them with a PGDip and facilitate their progression to an MSc. The team continues to provide in-house teaching and training of radiology registrars and wider postgraduate training, using virtual software.

Both consultant radiographers are also undertaking research during the pandemic. Our latest study is about the effectiveness of the GP reporting service in relation to GP satisfaction with report turnaround, terminology, and recommendations for follow-up.

They are also encouraging and assisting other staff members to write research articles for peer review journals.

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