An Introduction to Clinical Audit for Radiographers

12. Examples of audits relevant to a mobile chest radiography service

12.4. Accuracy and Effectiveness

Service Requirement Section D - Accuracy and Effectiveness
Criteria D1 D2 D3 D4
Did the CXR report answer the clinical question? Accuracy of CXR compared to CT or Covid-19 test result CXRs should have a positive impact on patient management (affect decision making) Accuracy of radiographer preliminary clinical evaluation
Example audit statement All CXRs will receive a recorded clinical report, and did this answer the question posed or refer for further imaging? The number of negative CXRs should be low in moderate/severe cases confirmed by CT All CXRs should have a positive impact on patient management Radiographer PCE / triage should reflect the definitive report
Purpose To ensure the CXR is able to influence patient management Review accuracy of CXR to consider where and when it is best utilised Ensure appropriate use of resources, reduce unwarranted exposures Review effectiveness of triage or immediate review for referring clinician; to highlight training needs
Indicator / Standard 100% (minimum standard) 80%* CXRs have positive findings (*local agreed figures) 100% CXRs should change management (ideal standard), 80% change management (optimal standard) 80%* PCE findings should concur with definitive report (*locally agreed standards depending on level of training)
Audit type Compliance Accuracy Effectiveness Accuracy / Effectiveness
Evidence / Previous audits / literature Need for all exposures to have a report:
No imaging for screening or mild Covid-19 symptoms: 
Prospective: In situ referrer template completion; Retrospective: case note and radiology report review Prospective: radiographer PCE checklist with limited choice to facilitate completion and comparison