Improving inappropriate radiology referrals: a template for imaging requests in Saudi Arabia

Abstract

Abstract Background Imaging requests are the first line of communication between the referring physician and the radiology department. The information provided allows the imaging team to choose the optimal examination for the clinical question. There are no imaging referral guidelines in Saudi Arabia. The Radiological Society of Saudi Arabia (RSSA) and Arabsafe have surveyed to develop an imaging referral tool in Saudi Arabia. This study aims to determine the most critical clinical information that should be included in an imaging request form in Saudi Arabia. Methodology A questionnaire was sent to the RSSA members to rank —using the Likert scale— the importance of 8 pieces of clinical information to discern what must be included in the imaging request form. Results The response rate was 80% of the RSSA members, which included 75 respondents, mostly Radiology consultants and residents in training. Radiologists carried different specialties and came from 4 main provinces in the Kingdom. 90.6% of Radiologists ranked the clinical question with relevant details as very important. The contact information of the requesting clinician came next in the ranking, with 82.3% scoring it as very important. The “very important” scores were 64.9% for the past medical history, 67.3% for past surgical history, 49.2% for laboratory, 38.3% for risk factors, and 56.7% for prior radiological studies. The RSSA-Arabsafe imaging request template was proposed because of the respondents’ votes to include all eight points: a clear clinical question relevant to the requested exam, the contact information of the referring physician, relevant surgical history, relevant medical history, past radiological tests if any, patient demographics, and relevant laboratory tests. Conclusions The RSSA-Arabsafe template is the first tool to improving imaging referrals and hence patients’ safety and services in Radiology departments in Saudi Arabia. It is crucial for healthcare institutions to actively implement standardized imaging request forms, such as the proposed RSSA-Arabsafe template, to reduce inappropriate referrals, enhance communications and optimize resource utilization.

Keywords

• Imaging justification
• Imaging appropriateness criteria
• Clinical decision support system
• RSSA-Arabsafe imaging request template
• Imaging referral guidelines