Clinicans' perceptions of the quality of outsourced radiology and actions taken around perceived imaging errors in practice

Objectives: Outsourcing of radiological reporting services has fundamentally altered communication between radiologists and clinicians in clinical decision making, which relies heavily on diagnostic imaging. The aim of this study was to understand clinicians’ perspectives and experiences of interpretation of outsourced reports in clinical practice, if the author of imaging reports matters to clinicians, and actions taken to deal with perceived errors. Methods A printed survey was distributed to a purposive sample of 50 of the 250 senior medical and surgical staff of a large National Health Service hospital in the United Kingdom who regularly engaged with the Radiology Department between May – October 2017, representing 20% of this hospital workforce. The survey consisted of 10 questions examining clinicians’ opinions on radiology reporting, with comment options to encourage respondents to give further detail. Participants were requested to return the survey to the study investigators. Results: The survey elicited a 100% response rate (n=50). A constant comparative framework was used to guide analysis, revealing themes relevant to the ongoing inter-professional relationship between clinicians and radiologists. The disparity between in-house and externally sourced radiology reports and underlying issues of trust surrounding outsourced reports were the most significant themes identified. Conclusions: This study found outsourcing of radiology reporting needs multi-disciplinary team availability regarding the interpretation and discussions around capacity for effective communication. It raises important issues around often under-acknowledged additional workloads imposed on in-house radiologists. There are financial and pragmatic clinical aspects in pathways of radiology practice which require further research and examination