Referral guidelines – will they deliver?
29 Sep 2014
Evidence-based imaging referral guidelines have been published for 25
years by the RCR. The need for guidance is based on good medical practice,
radiation safety and cost effectiveness. Powerful drivers in Europe and abroad
have been: imaging overutilization (cost) and increasing collective dose, with
diagnostic exposures now matching natural background radiation in some
countries.
Challenges to implementation of referral guidelines include availability,
distribution, resource, acceptance by referrers and obtaining evidence
of outcome. Strategies for promoting guidelines’ use include: increased
awareness, educational initiatives, clinical decision support and feedback.
International efforts to aid justification include the IAEA campaign of
“awareness, appropriateness and audit”, the WHO Global Initiative for
Radiation Safety in Healthcare Settings, the Bonn Call-to-Action, the
European Commission’s Guidelines Project RP178, and the European Society
of Radiology’s Eurosafe campaign. The term, referral guidelines (rather than
criteria) is used in the Basic Safety Standards and the Euratom BSS Directive.
Educational efforts include formal teaching eg MEDRAPET in Europe,
campaigns such as Eurosafe and Choosing / Image Wisely and webbased
learning eg IAEA’s Radiation Protection of Patients. Computerised
clinical decision support in workflow has much interest and should
support professional decisions with less need for later change through
vetting. Feedback through clinical meetings and in reports offers learning
opportunities to promote a radiation safety culture.
Evidence shows 20% sustainable reduction in utilisation is possible using
guidelines. Appropriate imaging is now possible in >90% of GP-exams
through meticulous vetting, thus making the best use of clinical radiology.
0.5 CPD credit.
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate. You must login to watch the video and receive CPD.
years by the RCR. The need for guidance is based on good medical practice,
radiation safety and cost effectiveness. Powerful drivers in Europe and abroad
have been: imaging overutilization (cost) and increasing collective dose, with
diagnostic exposures now matching natural background radiation in some
countries.
Challenges to implementation of referral guidelines include availability,
distribution, resource, acceptance by referrers and obtaining evidence
of outcome. Strategies for promoting guidelines’ use include: increased
awareness, educational initiatives, clinical decision support and feedback.
International efforts to aid justification include the IAEA campaign of
“awareness, appropriateness and audit”, the WHO Global Initiative for
Radiation Safety in Healthcare Settings, the Bonn Call-to-Action, the
European Commission’s Guidelines Project RP178, and the European Society
of Radiology’s Eurosafe campaign. The term, referral guidelines (rather than
criteria) is used in the Basic Safety Standards and the Euratom BSS Directive.
Educational efforts include formal teaching eg MEDRAPET in Europe,
campaigns such as Eurosafe and Choosing / Image Wisely and webbased
learning eg IAEA’s Radiation Protection of Patients. Computerised
clinical decision support in workflow has much interest and should
support professional decisions with less need for later change through
vetting. Feedback through clinical meetings and in reports offers learning
opportunities to promote a radiation safety culture.
Evidence shows 20% sustainable reduction in utilisation is possible using
guidelines. Appropriate imaging is now possible in >90% of GP-exams
through meticulous vetting, thus making the best use of clinical radiology.
0.5 CPD credit.
Watch the video and complete the online self-reflection form. Go to "My events" to download your certificate. You must login to watch the video and receive CPD.
Duration:24 mins
Speaker info
Denis Remedios
Dr Denis Remedios, Consultant Radiologist, Northwick Park Hospital Denis Remedios is a Clinical Radiologist working at Northwick Park Hospital, London. A graduate of Cambridge University and Westminster Medical School, his clinical interests include Musculoskeletal and Sports Imaging, helping at the 2008 and 2012 Olympic Games. He has chaired the Royal College of Radiologists’ Guidelines Working Party since 2003, for the 6th, 7th and forthcoming 8th Editions of iRefer: Making the best use of clinical radiology. He has also been a member of the RCR Clinical Radiology Audit Committee for over 10 years. International work includes European Society of Radiology Lead for the European Commission Guidelines Project, RP178 in 2012-3 and helping with several IAEA and WHO consultations.