Radiographer-led discharge in accident and emergency - The results of a pilot project

The radiographers role in trauma has been traditionally limited to image acquisition, but has evolved to include responsibility for image interpretation. The contribution to ongoing patient management has been limited, despite pressure on A&E systems to decrease any potential delays.

Three experienced reporting radiographers were trained to discharge patients with a normal radiology report or refer to A&E for further management, following a documented management plan by the examining clinician in A&E. Discharge included advice on the acute management of soft tissue injuries including analgesia and exercise.

Over a 4-month period in early 2004 all patients whose examinations received a report at the time of attendance (hot report) were included and data were collected in relation to those who were discharged including journey times and further A&E attendances. Data were also collected regarding patients recalled to the A&E department due to misinterpretation of radiographs during the study period.

The radiographers hot reported 1760 examinations, discharging 88 (5%) and referring a further 26 (2%) directly for treatment. The number of patients recalled due to misinterpretation of the radiographs was decreased by 52% when compared with the previous 3 years data.

Radiographers can safely extend their roles outside of the radiology department and contribute to the management of patients whilst decreasing risk of radiographic misinterpretation by A&E.