Direct Access Non-Obstetric Ultrasound Service
via AQP Qualification
Journey Overview
START
1. Referral &
Appointing
Global Diagnostics Ltd
US Pathway
May 2012
Patient referred to direct access ultrasound service
Referring clinician requests ultrasound examination from Global Diagnostics
Patient contacted within maximum of 5 working days and offered choice of
location and appointment time
Ultrasound appointment booked within 10 working days of receipt of referral
2. Clinical
Episode
Ultrasound examination undertaken by Advanced Practitioner Ultrasonographer
Examination undertaken to agreed local guidelines
Images stored direct to Global RISPACS system
Global Consultant Radiologist available for peer support via Global RISPACS
3. Results
Delivery
Images reported direct to Global RISPACS system
Images reported and verified by Advanced Practitioner Ultrasonographer
Verified reports delivered to referring clinician within 48 hours of examination
END
Patient returns to referring clinician for interpretation of results
AQP Direct Access Non-Obstetric Ultrasound
1. Referral and Appointing
Global Diagnostics Ltd
US Pathway
May 2012
Patient presents requiring
ultrasound examination
Information provided to all
referring clinicians to enable
signposting of most appropriate
diagnostic test for patients
Referring clinician advises patient
on choice of providers and
initiates referral
Global team available via
telephone for any referral
advice/enquiries
Referring clinician sends patient
referral form to Global
Diagnostics service (GP practices
can utilise Global merge referral
forms which auto populates
patient details from GP clinical
system)
Referral requested via
Choose & Book
Referral requested via
secure NHS.net email
Referral requested via
direct OrderComms
Referral triaged & protocolled by
Global team to determine if
request meets referral criteria
Yes
Patient contacted within
maximum of 5 working days of
receipt of referral to book
appointment
No
Referral returned to referring
clinician within 1 working day of
receipt informing of reason
for rejection
Patients will be offered choice
of appointment date and time
Patients to be appointed within
10 working days of receipt of
referral
Patient appointed on Global
RISPACS appointment
scheduler
Text/email reminder sent
to patient 24 hours prior to
appointment
Confirmation appointment letter
sent to patient detailing
examination process,
preparation instructions, results
delivery and chaperone
provision
Ultrasound scan undertaken by
Advance Practitioner
Ultrasonographer
Patient re-appointed within
2 weeks
Patient cancels appointment
Patient cancels appointment for
second time
Patient discharged back to
referring clinician
AQP Direct Access Non-Obstetric Ultrasound
2. Clinical Episode
Patient arrives for ultrasound
examination
Advanced Practitioner
Ultrasonographer or Assistant
escorts patient to consulting
room
Ultrasonographer confirms
patient details and ‘arrives’
patient on Global RISPACS,
automating transfer of
examination direct to
ultrasound modality worklist
Global Diagnostics Ltd
US Pathway
May 2012
Patient Does Not Attend (DNA)
for appointment
DNA Protocol followed:
Patient contacted to reappoint
after 1st DNA
Patient discharged back to
referring clinician after 2nd DNA
Ultrasonographer confirms
examination process, results
delivery and chaperone
provision to patient
Verbal consent will be obtained
for examinations and recorded
in patient report
Ultrasound examination is
undertaken to agreed local
and national guidelines
and protocols
Ultrasonographer notes coincidental
findings – additional area scanned and
reported to referring clinician.
Untoward findings are referred to
Global Consultant Radiologist for peer
review
Ultrasound images are
acquired in softcopy DICOM
format
Ultrasonographer performs
industry standard QA on such
The DICOM images are
automatically validated direct
to the Global RISPACS
Ultrasonographer reports
direct to Global RISPACS
Ultrasonographer verifies
report
Verified reports sent to
referring clinician within 2
working days of examination
via secure electronic transfer
Global Consultant Radiologist
available remotely for peer support
and discussion in respect of
complex cases
Global Diagnostics Ltd
AQP Direct Access Non-Obstetric Ultrasound
3. Results Delivery
Global Consultant Radiologist
available remotely for peer support and
discussion in respect of complex cases
within 24 hours of examination
US Pathway
May 2012
Advanced Practitioner
Ultrasonographer reports
ultrasound examination
contemporaneously direct to
Global RISPACS
Ultrasound DICOM compliant images
validated on Global RISPACS
Ultrasonographer verifies
completed report
Images available in PACS format
for onward transmission direct
from Global RISPACS to Acute
Trust PACS via NHS preferred
secure exchange portal
(Image Exchange Portal)
Normal
Findings
Unsuspected
cancer
Urgent &
Significant
Findings
Follow up
scanning
Upon Ultrasonographer
verification report sent to
referring clinician (and
patient’s GP if not referrer) via
preferred secure electronic
format
Ultrasonographer contacts
referring clinician via
telephone immediately to
advise of urgent
intervention and onward
referral required
Ultrasonographer contacts
referring clinician via telephone
within 4 hours to inform of
examination findings and need
for urgent patient intervention
In accordance with local and
National protocols if follow up
scanning is recommended
Ultrasonographer documents
findings and recommendation for
follow up examination within
report to referring clinician
Verified report available to
referring clinician post
examination or within 2 to 5
working days if Consultant
review initiated
Urgent verified report
detailing
recommendations for
urgent onward referral is
transferred via preferred
methodology to referring
clinician within 1 hour
Urgent verified report detailing
recommendations for urgent
intervention is transferred via
preferred methodology to
referring clinician within 4
hours
Verified report is transferred to
referring clinician via preferred
secure electronic format post
examination or within 2 to 5
working days if further
Consultant review initiated
Patient advised follow up
required
Images transferred to
appropriate Acute Trust via
secure Image Exchange
Portal within 1 hour
Images transferred to
appropriate Acute Trust via
secure Image Exchange
Portal within 4 hours
Referring clinicians are
notified on report of central
contact telephone number
should any further clarification
of report be required
Patient advised to contact
referring clinician for
examination results
Global bookings team alerted to
follow up required and
appointment is automated