Title : Ambulatory EMSU ultrasound audit
Abstract:
An audit was conducted within the Ambulatory General Surgery service to evaluate the appropriateness and efficiency of ultrasound scan requests. Initial review identified significant variation in requesting practices, including inconsistent clinical information, inappropriate indications, duplication of imaging, and limited patient understanding regarding the purpose and timing of scans. These issues contributed to delays in patient flow, increased radiology workload, and occasional tension between surgical and radiology teams due to unclear or low-yield requests.
Baseline data were collected over a defined period and assessed against local and national imaging guidance and accepted standards for ambulatory surgical practice. The audit demonstrated that a considerable proportion of ultrasound requests lacked sufficient clinical justification or failed to meet recommended criteria. In addition, patients frequently reported poor understanding of why scans had been requested and what outcomes to expect, resulting in repeated queries, dissatisfaction, and inefficiencies during follow-up.
To address these concerns, a quality improvement intervention was introduced focusing on two main components: enhanced clinician counselling techniques and the implementation of a QR code-based educationalresource for patients. The QR code linked patients to accessible information explaining the role of ultrasound imaging, common indications, preparation requirements, expected timelines, and potential outcomes.Surgical clinicians were also encouraged to adopt a more structured counselling approach during consultations, ensuring patients understood the rationale for imaging and helping clinicians reflect on the appropriateness of requests prior to submission.
Following implementation, re-audit data emonstrated a marked improvement in the quality and appropriateness of ultrasound requests. Requests contained more relevant clinical information, adhered more consistently to departmental guidance, and showed a reduction in unnecessary or duplicate imaging. The intervention also improved patient engagement and understanding, reducing confusion and improving attendance and preparedness for investigations.
Importantly, the project had a positive impact on interdisciplinary working relationships. Improved request quality and clearer communication enhanced collaboration between the surgical and radiology departments. Feedback from radiology colleagues highlighted greater confidence in the clinical value of requests and reduced frustration associated with incomplete or inappropriate referrals. Surgical teams also reported improved awareness of imaging indications and more efficient patient management within the ambulatory pathway.
Overall, this audit demonstrated that combining digital patient education tools with improved counselling strategies can significantly enhance the efficiency and appropriateness of ultrasound requesting in ambulatory general surgery. The project highlighted the value of simple, low-cost interventions in improving patient care, streamlining workflow, and strengthening interdepartmental collaboration.
