eP73 “Why Radiology Requests are not Being Accepted”, a quality improvement audit in a surgical department

Aim Radiology requests serve as the primary communication tool between clinical physicians and radiologists, enabling radiologists to provide accurate diagnostic support. This audit aimed to evaluate the radiology request acceptance rate, identify common reasons for request rejections, and implement measures to improve request quality. Method According to the Royal College of Radiologists, radiology requests should include comprehensive and relevant information, although specific content requirements are not defined. The audit was conducted in two cycles: the first in September-October 2023 and the second in August 2024. Patients were randomly selected from clinical handover records and SACU clinic logs. Radiology requests on the TrakCare system were reviewed to determine their acceptance status, assess the quality of information provided, and identify reasons for requests being placed on hold. Results During the first audit cycle, 73% (52/71) of radiology requests were accepted. The primary reasons for rejections included inappropriate imaging (21%, 4/19), duplicate requests (21%, 4/19), and insufficient clinical details (21%, 4/19). Following these findings, a structured request format was developed, and staff were educated on its use. In the second audit cycle, the acceptance rate improved significantly to 89% (89/101). Conclusions A high-quality radiology request should include a concise patient background, current symptoms, examination and investigation findings, relevant differential diagnoses, and the clinical situation. Radiology requests should be presented as well-informed proposals rather than directives. Implementing a structured request format can enhance communication, optimize resource utilization, and expedite patient care planning for improved outcomes.