QUDI Projects 2004-08

The initial phase of the QUDI Program (QUDI 2004-08) was established under the Radiology Quality and Outlays Memorandum of Understanding and managed by RANZCR through a funding grant of $1M per annum over five years. The Program developed a framework for a systems and evidence-based approach to the appropriate and quality use of diagnostic imaging services in Australia.

The projects were organised into four streams of work, representing different perspectives on quality radiology services: consumers, referrers, radiologists and economic sustainability.

Quality consumer services:

These projects aim to develop and improve consumer-focused, accessible and coordinated services that promote informed choice and meet consumer needs.

Consumer roles in accreditation

This project investigated the current role consumer advocates play in the development and implementation of the practice accreditation program. The report made recommendations about expanding the role of consumer groups in, and increasing consumer knowledge about, the accreditation process.

Consumer information strategies

This project sought to understand what consumers and health professionals experienced and expected from information about diagnostic imaging (Part One). It then developed and recommended strategies to best meet these expectations (Part Two). The findings form the basis for the consumer and health professional radiology information items on this website.

Radiologists in multidisciplinary breast cancer care teams

This project sought to identify the extent to which radiologists are involved in multidisciplinary teams, the barriers and enablers to their involvement and to consider strategies that will assist radiologists to participate more widely in what is recognised as an effective model of patient management.


Quality referrals

These projects aim to support referrals that are best practice, evidence-based and facilitate the most appropriate radiology service.

Scoping study of e-health (2005-06)

This project aimed to develop an understanding of the current and future role of information and communication technology in radiology. It makes a number of recommendations about key areas of ICT development in the radiology sector.

Standards for portable media (2007-08)

Part One consisted of a small exercise to test the compliance of a sample of radiology image CDs to international standards. It found that many did not conform, highlighting concerns from referring health professionals about the quality, usability and acceptability of portable media such as CDs.

Part Two involved an industry workshop to introduce Australia to the Integrating the Healthcare Enterprise profiles for portable media in digital imaging and developed guidelines for their standardised use. The report informed the RANZCR Standards of Practice, v9.0.

Radiology and general practice (2008)

This project explores enablers and inhibitors to more effective communication between general practitioners and radiologists, using the RACGP Quality Framework and a series of focus groups as the basis for analysis.

Review of diagnostic imaging referrals (2005-06)

This project evaluated the diagnostic imaging referral process from a range of perspectives.

Radiology referral template (2007-08)

This project aimed to standardise and improve the way important information is communicated between referrers and radiologists. A series of referral forms for electronic and handwritten use were developed, sections of which can be customised for specialised referrals (e.g. women's health) and for practice information. The referral templates are available on request (please use the feedback form) in the Adobe In-Design file format, the software used to develop the forms.

Phase One of this project collected a broad range of existing referral forms; validated the existing data content and addressed issues that had been identified through a previous QUDI project (Review of diagnostic imaging referrals).

Phase Two involved piloting a revised prototype form with the DI profession and professional organisations representing key referrer groups. After further refinement of the form a small field trial was held with senior practice staff of 5 radiology practices representing a cross section of practice types and corporate models. This trial represented the process of development of the forms to the requirements of the practices, based on the standard form template.

The field trial demonstrated great heterogeneity in the way referral forms were used. Some DI services have settled on one multipurpose form (and these influenced the original concept design). Other services have developed a series of forms for particular purposes covering setting (hospital or community), modality type (MRI), referrer type (dental and chiropractic), patient type (women's health), and referrer preferences (A5 versus A4, handwritten versus computer, pre-printed referrer details, and checkbox data entry versus free text).

It became clear that offering only one multipurpose form type would meet resistance from many practices. Hence, a new model was developed which maintained the core design principles, while providing choice and flexibility about form design as well as customisation potential. Both A4 and A5 formats are developed for all forms except the computer form, where A4 is the only standard stationary size.

A multilayered design format was created using a commercial graphic and form design product. The base layer is a form template, which is the computer version and contains practice customised features such as letter head, reverse page content, and customised content in the area reserved for this. Additional layers are overlaid on this template in response to DI service requirements with each of these representing a standard format for that type of form component. Finally it is possible to then remove optional form content that is not required to meet local practice or referrer needs. The design process is one of selection of the form type and then subtraction of data or form features which are not required.

The content of the forms provides a consensus data model which could be taken up by health IT systems supporting electronic order entry. The standard paper design will make the job of printing referrals less expensive and more reliable. The final report of the project discusses the development process, outcomes and recommendations in more detail.

Allied health referrals (2006-07)

This project developed a broad set of principles which could apply to all allied health practitioners seeking rights to request diagnostic imaging services. These principles were based on research which found disparities in referral practices between allied health and general practice.

Critically Appraised Topics (2007-08)

This project developed a searchable database for critically appraised topics in radiology. In order to help populate the database, a training program was also developed to improve the critical appraisal skills of radiologists.

Clinical scholars in Evidence Based Practice (2007-08)

This project provided support and training for a clinical scholar in literature searching, study appraisal and synthesising evidence. The intention was to create a method for any clinician to undertake a critically appraised topic in radiology.

NICS-RANZCR Fellowships (2006-10)

The National Institute for Clinical Studies (NICS) - RANZCR Fellowships were instituted to give radiologists the opportunity to undertake a project to address an evidence-practice gap in current radiology practice. Three Fellowships have been offered:

  • Dr Taryn Bessen: Improving the uptake of imaging guidelines in the emergency department, 2006-08
  • A/Prof Stacy Goergen: Promoting evidence-based diagnostic testing for suspected venous thrombo-embolism, 2006-08
  • Dr Felicity Pool (NICS-RANZCR-National Breast and Ovarian Cancer Centre Fellow): Optimising communication about breast imaging using a structured reporting and classification system.


Quality radiology services

These projects aim to ensure safe, efficient and cost effective radiology services.

Professional supervision and reporting standards for radiologists (2005)

The standards developed by the consultancy define the principles and requirements of professional supervision and reporting that radiologists are expected to meet.

Role Evolution (2005)

This project examined the evolving roles of non-medical diagnostic imaging staff.

Closing the Loop (2007-08)

A survey provided data on how emergency departments communicate with radiology departments or practices, and examined the risk that poor communication "loops" pose to patient safety. The findings provided some recommendations on how communication in emergency imaging can be enhanced.

Accreditation requirements for teleradiology (2004-07)

This project provided recommendations for technical and practice standards for teleradiology, which were used to inform the RANZCR Standards of Practice.

Credentialling requirements for radiology in Australia 2005-06

This project examined whether an Australian system for the credentialling of radiologists is both feasible and desirable.

Radiology Events Register (2006-08)

This project represents a world first initiative in radiology and would place radiology at the forefront of systematic attempts to improve the quality of care and patient safety. The initiative has obtained broad support both nationally and internationally and is aligned with RANZCR's strategic directions and the Australian Government Department of Health & Ageing’s stated desire to encourage the quality use of diagnostic imaging.

Paediactric CT Dose Optimisation Project (2006-07)

This initial quality improvement activity involving specialist paediatric radiology practices for common multi-detector CT investigations demonstrated:

  1. Optimisation training can positively influence paediatric CT patient dosimetry;
  2. There are no universal ‘right’ or ‘target’ dose answers;
  3. Appropriate optimisation application depends upon the technical expertise of users and scientific support staff;
  4. Practices should work towards development of local DRL values and optimized dose-image quality relationships, and
  5. This survey technique could be expanded into a National survey to establish baseline comparative DRL values for many common CT acquisition protocols.


Economically sustainable services

These projects support affordable, sustainable diagnostic imaging services.

Post-implementation review of radiology practice accreditation (2005)

This project identified issues associated with the voluntary practice accreditation and informed the development of the proposed mandatory accreditation program.

Promoting public awareness of the appropriate use of diagnostic imaging (2005-06)

Using acute low back pain as the representative condition, this project explored the reasons for inappropriate use of diagnostic imaging, particularly the role that consumer demand plays.

New technology assessment (2006)

This project examined health technology assessment in Australia and provided recommendations for streamlining the process.


Date last modified: 7th March 2014