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PROTOCOLS
Radiology emergency imaging protocols.
These evidence based imaging protocols have been agreed with Diagnostic Imaging, the Emergency Departments at Monash Medical Centre, Casey Hospital, and Dandenong Hospital, and the relevant inpatient specialist units within Southern Health.

The protocols are derived from the best available evidence and assist the clinician in determining which patients require imaging at all and which test is likely to be the most appropriate to the clinical question.

Good quality evidence-based protocols can increase uniformity of care, reduce medicolegal risk, and reduce inappropriate use of diagnostic testing with its resulting consequences of potential inappropriate treatment, inappropriate further investigation, and unnecessary exposure to ionizing radiation.

Each of the protocols is referenced with the evidence sources from which it was derived. Each protocol is also associated with a date of implementation and version number to facilitate planned review and updating in the future as new evidence becomes available.
CONSENT FORMS
Ethically, it is imperative to include patients in radiology decision-making because:
patients are better educated as a result
nowadays, treatment choices are greater than ever
society has moved toward greater community participation in decision making.
Informed consent should be a shared decision-making process.

Doctors and patients should participate in discussion about risks and benefits so that beliefs and attitudes of the patients become evident.

The patients make the final decision, based on the information, advice, and discussion with doctors. In this way, the patients are more likely to “own” the decision.
Patient information sheets or consent forms are useful because they:
provide consistent information to patients
allow patients to talk to their own doctor, and their family and friends, to become familiar with the information before arriving in the radiology department
The following radiology consent forms are available:
TRAFFIC LIGHTS
The "Traffic Lights" system is an automated, stratified system of radiological test ordering, aimed at reducing the number of unnecessary tests and their associated costs.

The system involves stratification of radiological tests into three groups, denoted by red, amber, and green colours.
"Red" tests must be authorised by a consultant. "Amber" tests must be signed by a registrar or authorised by a consultant. "Green" tests can be ordered directly by residents or interns.

In the four months following introduction of "Traffic Lights", each radiological modality demonstrated a reduction in both the number of tests and their associated costs. The reduction was consistent across both medical and surgical groups.

Analysis of data 20 months immediately after the introduction of ‘Traffic Lights’ also showed a consistent reduction in the total number of tests, suggesting that the changes are sustainable and unlikely to be due to seasonal variation.

Combined with evidence-based medicine protocols, this stratified system of radiological test ordering should ensure the safety, quality, and appropriateness of imaging tests, and minimise overall patient radiation dose.
NEWS
In Diagnostic Imaging at Southern Health, we continually strive to improve our services by installing and maintaining the latest equipment and providing our clients with the best technology. Our objectives for 2006 include the installation of three new ‘state of the art’ gamma cameras in our Nuclear Medicine department, the replacement of the fluoroscopy unit at Dandenong Hospital and the electronic delivery of results directly to the General Practitioner.

Nuclear Medicine.

The Nuclear Medicine Department at Monash Medical Centre plans to update the entire fleet of aged equipment in 2006/2007. The three new gamma cameras will allow Southern Health to provide the latest nuclear medicine imaging services to our clients. These will include dedicated cardiac imaging and CT SPECT with attenuation correction and image co-registration. Patient access to services and examination outcomes will improve as a result of the planned replacement.

Fluoroscopy.

The Fluoroscopy unit at Dandenong Hospital will be updated in 2006/2007. The new fluoroscopy room will enable improved access to fluoroscopy procedures, including standard barium studies, minor interventional studies and paediatric examinations. The new room will enhance patient safety, access and outcomes.

Electronic Results Delivery.

Casey Hospital has been trialing the electronic delivery of results to General Practitioners (GPs). The trial has enabled radiology reports to be directly delivered into the doctor’s patient management system. It is hoped to roll this service out for wider distribution from Southern Health during 2006/2007. The system will improve the speed of report access and allow GP’s with compatible software to improve their risk management strategies and improve patient care.
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