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Audit to Assess the Quality of MRI Knee Requests After the Introduction of the Extended Scope Physiotherapist (ESP) Facility
Poster Title: Audit to Assess the Quality of MRI Knee Requests After the Introduction of the Extended Scope Physiotherapist (ESP) Facility
Submitted on 27 Sep 2018
Author(s): Dr. J. J. Joshi, Dr. P. N. Patel
Affiliations: Radiology
This poster was presented at BIR Annual Congress 2018
Poster Views: 546
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Poster Information
The introduction of ESPs to alleviate pressures on primary and secondary healthcare has resulted in an increasing number of MRI knee requests. Consequently, this places imaging departments under further pressure to scan patients in a timely fashion whilst trying to deal with the ever-increasing waiting lists. It is imperative for all practitioners to follow local guidelines and request imaging appropriately whilst imaging departments ensure that these requests meet the appropriate criteria.

This retrospective audit was performed at the Luton and Dunstable NHS Hospitals Trust. The radiology information system was used to identify 20 patients referred by ESPs and 20 patients referred by orthopaedic doctors who had undergone an MRI knee over a three-month period. Trust guidelines for referral created by the MSK radiologists was used as the target criteria.

100% of orthopaedic requests and 65% of ESP requests were appropriate.
70% of orthopaedic requests and 100% of ESP requests contained appropriate clinical information.
95% of orthopaedic requests and 45% of ESP requests offered differential diagnoses.
60% of orthopaedic requested MRIs and 25% of ESP requested MRIs matched the suspected diagnosis.

ESP requests were not fully compliant with local guidelines but a higher proportion contained appropriate clinical information. Orthopaedic requests were of a better quality as a much higher percentage of requests offered differential diagnoses and the examination findings matched the suspected diagnosis. Improving familiarity with referral guidelines and proforma-based requesting may improve quality of requests and reduce inappropriate examinations which negatively impact waiting times.
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