Classification and Communication of Critical Findings in Emergency Radiology: A Scoping Review

Area of Science:

• Radiology
• Medical Communication
• Healthcare Standards

Background:

• Critical actionable findings (CFs) in emergency radiology require standardized classification and communication.
• Effective management of CFs is crucial for patient safety and timely intervention.

Purpose of the Study:

• To identify published standards for classifying and communicating critical actionable findings in emergency radiology.
• To determine associated facilitators and barriers in communication and message management of these findings.

Main Methods:

• A systematic search of PubMed and Embase databases was conducted for resources on critical findings in emergency radiology.
• Inclusion criteria focused on standards for classifying/communicating critical findings, or discussing facilitators/barriers. Resources on pediatrics or AI/NLP were excluded.
• A gray literature search supplemented the database search, with data extraction on various study characteristics.

Main Results:

• Seventy-six resources were analyzed, including 16 guidelines; no standardized list of CFs was identified, with recommendations for local policies.
• Communication standards varied, with direct closed-loop communication for high acuity findings and flexible channels for less acute ones.
• Interventions for CFs management included electronic, hybrid, feedback/education, and administrative approaches.

Conclusions:

• Published standards, policies, and interventions exist for managing critical actionable findings in emergency radiology.
• A three-tier stratification (critical, urgent, incidental) is common, with most CFs requiring closed-loop communication.
• Local policy development should consider systemic facilitators and barriers, with electronic/administrative pathways as useful adjuncts.