The SoR’s clinical guidance document on radiographer Preliminary Clinical Evaluations has received an update to emphasise their role as a safety net in emergency departments when a definitive clinical report is not immediately available.
This update brings the role of Radiographer Preliminary Clinical Evaluation (PCE) as a clinical safety net to the fore.
It emphasises that when imaging services cannot provide an immediate definitive clinical report for a patient receiving clinical imaging in the emergency department, providing a diagnostic radiographer PCE can support referrers and minimise potential risks.
Safety net approach
This guidance sets out the background, justification and evidence for radiographer PCEs, and proposes a toolkit for local service implementation.
The review and update were undertaken by a team of dedicated radiographers, formed by a subgroup consisting of a team of volunteers from the SoR Diagnostic Imaging Advisory Group and the Consulting Radiographer Advisory Group.
Definitive clinical reports remain the “gold standard” for emergency care, the guidance maintains.
It is only when this gold standard cannot be met that a radiographer PCE at the time of imaging can provide a safety net by reducing the potential for referrer interpretation errors.
The guidance explains: “A PCE is therefore intended for use when referrers are viewing radiographs in the absence of a definitive clinical report.”
Greater use
Most PCE systems have been implemented to support referrers within emergency departments (EDs), but PCEs have immense potential to support referrers and services across healthcare settings, including community diagnostic centres (CDCs), urgent and primary care, same-day emergency care and walk-in and ambulant care centres, the guidance adds.
PCE should be used in situations where an immediate radiographer comment could prevent referrer interpretation error, and will also support time sensitive care.
Included alongside the recommendations for implementation and toolkit for doing so is the evidence base for the document, which demonstrates that well-structured and resourced PCE systems, with regular training, education, audit and feedback mechanisms can be safe and effective.
However, there is currently little empirical evidence of the direct effect of PCE on patient outcomes – which is why PCE service evaluation and research should seek to build this evidence base.
AI and future usage
Tracy O’Regan, professional officer for clinical imaging and research at the SoR, explained the authors were conscious of the potential for artificial intelligence and AI-derived computer algorithms to assist with the identification of abnormalities, including fractures, and to augment decision-making for skeletal imaging in the future.
She said: “The implementation of AI systems in clinical practice is not yet at a stage of full technology evaluation, and future recommendation for their routine use in clinical practice will be in line with a demonstrable evidence base.
“As the evidence base develops, the guidance in this document will be reviewed to ensure the best use of staff skills and innovation for patient outcomes and experience.”
The SoR would like to offer thanks to the team of authors for their work and guidance on the publication of the document.
More information can be found online here.
(Image: Photo by JazzIRT via GettyImages)