Interpretations of chest x-rays by radiographers and general practitioners at district hospitals in the city of Tshwane

Abstract

The public health care system is at the core of transforming health services in South Africa. The effectiveness of patient service delivery in hospitals is highly dependent upon the ability to provide timeous, adequate diagnostic radiography and an immediate radiology service, to support and influence patient management. A shortage of radiologists restricts continuity in radiology services and causes a delay in diagnosis, compromising the overall quality of service to patients. The first point of entry to health services is at primary level through local clinics or primary health care hospitals. After clinical examination by general practitioners (GPs), many patients are referred for imaging to the X-ray department in district hospitals. A chest X-ray is one of the first-line diagnostic tools for GPs to diagnose, monitor treatment and predict the outcomes of many diseases. GPs are mandated to give reports on all chest X-ray images taken at district hospitals and they sometimes request image interpretation assistance from radiographers. The aim of this study was to explore methods used by radiographers and GPs to perform image interpretation on chest X-ray images at district hospitals in the City of Tshwane. A qualitative descriptive collective case study method with purposive sampling was used. Results showed that radiographers searched with a specific pattern of inspection and the GPs used a free global search by scanning X-ray images without a preconceived orderly pattern. It was concluded that the methods used by both radiographers and GPs for chest image interpretations were not systematic in approach and that inter-professional communication was limited. No protocols were in place to promote communication.