Hospital Doctors Unaware of Referral Rules
A recent study revealed that 72.9% of non-consultant hospital doctors in a Model 3 hospital had no awareness of the Royal College of Radiologists’ iRefer guidelines. The investigation combined a quantitative questionnaire with qualitative interviews to assess how doctors navigate diagnostic imaging referrals.
Out of 90 distributed questionnaires, 70 responses were returned. Beyond the lack of familiarity with the RCR guidelines, 62.9% of respondents were unaware of their legal responsibilities as referrers under Statutory Instrument No. 256 of 2018. When facing complex cases, 70% of surveyed doctors relied on advice from senior colleagues rather than consulting decision-support tools directly.
Legal Obligations and Systemic Barriers
Diagnostic imaging referrals carry statutory weight under Irish law, requiring referrers to justify medical exposures.
A separate study noted that high clinical workloads and complex guidelines often impede guideline adherence among physicians in training, pointing to the need for easy access to relevant guidelines at the point of care.
Recommendations for Clinical Governance
The study authors recommended mandatory radiation protection and referrer training at induction, embedding indication-based prompts into the imaging ordering system, and formalising communication pathways between ordering clinicians and radiology.
Frequently Asked Questions
What specific hospital setting was evaluated in this study?
The research was conducted at a single Model 3 hospital in Ireland, which provides acute medical and surgical care but lacks the full complexity of tertiary (Model 4) centres.
How many clinical scenarios were tested in the survey questionnaire?
The questionnaire tested respondents across three clinical scenarios, with only 5.7% of participating doctors answering all three scenarios concordantly.
What national statutory instrument governs medical radiation exposures in Ireland?
Statutory Instrument (S.I.) No. 256 of 2018 places defined duties on referrers regarding the justification of medical exposures.
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