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Abnormal x-ray tracking

By Josie Roberts & Suzanne Davies, Rotherham General Hospital

Category: Pre-Diagnosis and Referral

The problem identified

Due to the increasing numbers of chest x-rays requested from many different areas, delays are occurring and potentially abnormal x-rays are missed. To prevent delays or missed diagnosis of lung cancer, we commenced an abnormal x-ray tracking system whereby radiologists apply an alert system to reports containing any suspicion of lung cancer. Reports are collected and audited to ensure appropriate and timely referrals are made to respiratory physicians within the trust.

The intervention made to change the problem

Tracking the x-ray reports ensures that general practitioners (GPs) and referring clinicians are aware of the need for referral to the specialist team. This enables GPs to clarify the referral criteria for abnormal x-rays. Weekly collection of x-ray reports, maintenance of a tracking database and auditing has become normal procedure. To date four potential missed diagnosis have been identified and dealt with appropriately through this tracking system.

How it changed my practice

The system has been clearly identified within the trust as a risk prevention measure and this has now been applied to all tumour site specific areas. The system creates approximately 3 hours work a week and is now a routine part of the workload. It ensures timely referral but also provides insight into why patients may not have been referred to the specialist team.


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