Patients’ journeys through multi-level diagnostic imaging referrals

Abstract

BACKGROUND : Diagnostic imaging plays an integral role in disease diagnosis and patient treatment. The challenge in the context of diagnostic imaging referrals is how to collectively navigate patients through these services, intra- and inter-institutionally. OBJECTIVE : To map the referral processes and procedures that lead to access to diagnostic imaging services within the embedded multi-level medico-clinical pathways up to the point of an ultimate diagnosis as part of a patient’s treatment and management plan. METHODS : This study was part of a larger qualitative study conducted at a district hospital situated in an academic hospital complex. A total of 24 conveniently selected patients were ‘shadowed’ from entry until discharge. Data collection methods included observations of the various types of consultations and individual and focus group interviews with multiple healthcare providers. FINDINGS : Two main themes pertaining to referrals for diagnostic imaging were identified. The first relates to the decisions that a medical officer or specialist has to make about the sequence of activities and procedures related to each patient’s condition. The second theme refers to the multi-level routing of patients. CONCLUSION : The informational interactions between providers that takes place during a patient’s journey inform the mapping approach to referral pathways for diagnostic imaging investigations from a systemic point of view. This process can also enhance the strategic management of the system.