Does radiography advanced practice improve patient outcomes and health service quality? A systematic review

yesObjectives To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. Methods Using the World Health Organisation definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs and data were systematically extracted using electronic data extraction proforma. Results 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n=7) focussing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The papers were generally considered to be of low to moderate quality with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No papers reported data relating to time to diagnosis, time to recovery or patient mortality. Conclusions Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. Advances in knowledge This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality. Powered b

Radiographer reporting in the UK: A longitudinal analysis

YesRadiographer reporting of plain film radiographs is an established role in the UK. Despite this previous research has demonstrated widespread inconsistencies in implementation, scope and utilisation. A cross-sectional postal survey was undertaken to provide a longitudinal insight into changes in radiographer reporting practice. The sample comprised all individual hospital sites in the UK, Channel Islands and Isle of Man with both a radiology and trauma service A response rate of 63.7% (n = 325/510) was achieved. Reporting radiographers were in place at 179 sites (55.1%) but less likely to be employed at sites with a minor injury unit rather than a full emergency department (χ2 = 71.983; p < 0.001; d.f. = 1). Radiographer utilisation has increased since 2007, although local barriers to implementation and activity were identified. Geographical variation was evident in relation to reporter employment and anatomical scope. A significant association was noted between broader anatomical scope and a wider range of referral sources (χ2 = 34.441; p < 0.001; d.f. = 1). Delayed reporting of radiographs remains the standard service delivery model across the UK. This study confirms the significant contribution that radiographers are making to reporting capacity in the UK, although there continue to be geographical variations, particularly around anatomical scope and referral groups