Communication of Urgent or Unexpected Imaging Findings Audit

Free projects are complete and ready to use. Paid projects can also be adapted to your local requirements. This project uses a fixed Lazomis clinical configuration of 42 audit criteria across cohort and imaging context, alert category and report clarity, alert generation and notification, acknowledgement and closed-loop communication, action on the imaging finding, patient communication and digital notification, fail-safe, tracking and unresolved alerts, and handover and continuity. Data collection, dashboards, findings, improvement planning, re-audit and every output are included at no cost.

• Radiologists, reporting radiographers, radiology managers and radiology governance leads
• Referring clinicians in emergency, acute, surgical, outpatient and general practice settings
• Cancer pathway, MDT coordination and results-management teams
• QI, patient safety and clinical governance leads, and trainees needing ARCP-ready evidence

• Measure whether urgent, critical or unexpected significant findings are categorised and clearly highlighted in the report
• Review whether alerts are generated, routed to the correct clinician or service and sent within local timeframes
• Review acknowledgement, closed-loop communication and redirection of misdirected alerts
• Review whether recommended action, cancer pathway referral and follow-up are documented and completed
• Review fail-safe tracking, escalation of unresolved alerts and responsibility after discharge or transfer
• Generate governance-ready and ARCP-ready evidence

• Anonymised case number, imaging provider, requesting setting, reviewer role and data source
• Modality, report type, alert category, finding type, cancer suspicion status and amended-report status
• Notification method, recipient role, notification timing, acknowledgement status and action status
• Patient communication method, digital notification use, fail-safe status and closure status
• 42 fixed audit criteria (Yes / No / Not applicable)
• Free-text learning points

• Live dashboard
• Audit report (Word)
• Executive summary (Word)
• Excel workbook
• PowerPoint presentation
• Conference poster
• ARCP evidence summary

This ready-built project is developed using the guidance, standards and authoritative sources listed below, so you can see what is being measured and why. Lazomis QI does not publish or own this guidance, and inclusion here does not imply endorsement or approval by any of these organisations.

• Royal College of Radiologists / Academy of Medical Royal Colleges

  Recommendations on alerts and notification of imaging reports(opens the original source in a new tab)

  National recommendations on alert categories, notification routes, acknowledgement and fail-safe communication of imaging findings.

• Royal College of Radiologists

  Standards for the interpretation and reporting of imaging investigations(opens the original source in a new tab)

  Professional standards for report content, clarity of significant findings and recommended action wording.

• Royal College of Radiologists

  Quality Standard for Imaging (QSI) and AuditLive audit templates(opens the original source in a new tab)

  Quality standard and ready-made audit material covering alert notification, fail-safe systems and results communication.

• NHS England

  Patient digital access to diagnostic imaging reports(opens the original source in a new tab)

  Guidance on patient digital notification of diagnostic imaging reports, which supplements but does not replace clinician notification where local policy requires it.

• Health Services Safety Investigations Body (HSSIB / HSIB)

  Investigations into communication and follow-up of unexpected significant findings(opens the original source in a new tab)

  National safety investigation learning on failures in communication, acknowledgement and follow-up of unexpected significant radiological findings.

• Designed to use anonymised or pseudonymised audit identifiers.
• This tool supports, but does not replace, clinical judgement.
• Local policy, formulary and specialist advice should be followed.
• Organisations remain responsible for local governance arrangements.
• This tool supports clinical audit and quality improvement. It does not replace clinical judgement, radiology reporting standards, local alert policy, diagnostic governance processes, specialist advice or urgent escalation pathways.
• The tool does not assess diagnostic accuracy and does not decide whether an imaging finding is clinically significant.
• Critical, urgent, unexpected significant or actionable imaging findings should be communicated and escalated according to local policy without waiting for audit activity.
• Patient digital notification may support safety but must not replace required clinician, referrer or service notification where local policy requires direct communication.
• Local radiology alert, fail-safe, cancer pathway, ED, GP, outpatient, inpatient, MDT, discharge, handover, patient communication and diagnostic governance policies should be followed where applicable.
• Use anonymous case identifiers only — never patient-identifiable information.

Supporting guidance from the Lazomis QI Resource Library. Authoritative clinical standards referenced by this project remain separate.

• Clinical GovernanceLeveraging Incident Themes for Quality Improvement and Patient SafetyThis guide helps NHS teams identify and analyse recurring incident themes, transforming reported safety events into practical quality improvement opportunities to enhance patient safety and system reliability.
• Patient SafetyDiagnostic Delay: Understanding and Mitigating a Critical Patient Safety RiskDiagnostic delay is a significant patient safety concern across all healthcare settings. This guide explains why timely diagnosis is crucial, details the common factors contributing to delays, and provides actionable strategies for healthcare professionals and teams to mitigate these risks.
• Patient SafetyHow to Select a Patient Safety Quality Improvement ProjectThis guide helps NHS teams identify and select patient safety quality improvement (QI) projects that are impactful, achievable, and aligned with organisational and national priorities. Learn how to move from identifying concerns to choosing a focused and measurable project.
• Patient SafetyIntegrating Patient Safety and Quality Improvement: A Practical Guide for UK CliniciansThis guide explains the foundational principles of patient safety and quality improvement (QI) within the UK healthcare context, offering practical strategies for clinicians to enhance safety and improve care delivery.