Delayed Investigations Impact Audit

This project audits the quality, timeliness, documentation and impact of investigations that were requested, awaited, delayed, not completed, not reported, not reviewed or not acted on within locally expected timescales. It reviews request quality, delay recognition, result review and action, escalation, ownership, handover, discharge planning and safety-netting, and shows where delay contributes to diagnostic delay, treatment delay, prolonged stay or avoidable clinical risk.

• Acute medicine, emergency medicine and general internal medicine teams
• Radiology, endoscopy and pathology pathway leads and diagnostic service leads
• Ward leaders, nurses, ACPs and physician associates
• Discharge coordinators, site, patient-flow and clinical operations teams
• QI leads, governance teams and educators

• Measure documentation of investigation indication, request details, urgency and expected timeframe
• Identify delay points, delay categories and recognition of delay against locally configured timeframes
• Assess result review, escalation of abnormal results, ownership, handover and safety-netting
• Identify variation by clinical area / location, investigation type and delay category
• Generate governance-ready and ARCP-ready evidence

• Anonymous case identifier
• Inclusion / eligibility decision
• Anonymised biodata (age band, recorded sex/gender, care setting, assessment context)
• Investigation type, delay category and documented impact of delay
• Clinical area / location and optional specialty / service
• Fourteen delayed-investigation audit criteria (met / not met / not applicable)
• Free-text learning points and any project custom fields

• 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.

• NHS England

  Diagnostic waiting times and activity(opens the original source in a new tab)

  National reporting definitions and guidance for diagnostic waits and activity, where relevant to the pathway being audited.

• NHS England

  Diagnostics: Recovery and Renewal (Richards review)(opens the original source in a new tab)

  National framing for diagnostic service improvement, capacity and separation of acute and elective diagnostic pathways.

• NHS England

  National elective access policy(opens the original source in a new tab)

  National rules for elective and diagnostic waiting-time management, to be read alongside the local access policy.

• NHS England

  Getting It Right First Time (GIRFT)(opens the original source in a new tab)

  Specialty and diagnostic pathway reports relevant to diagnostic bottlenecks, reporting turnaround and pathway design.

• 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, but does not replace, clinical judgement. Follow local policy, diagnostic pathways and specialist advice.
• 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.

• Hidden CapacityUnlocking Hidden Capacity in NHS Diagnostic ServicesThis guide provides practical strategies for NHS teams to identify and unlock hidden capacity within diagnostic services, aiming to improve patient flow and reduce waiting times across the UK.
• Service RedesignBottleneck Analysis in Healthcare: Identifying and Resolving Flow IssuesThis guide provides a practical framework for identifying and resolving bottlenecks in healthcare services, enhancing patient flow and operational efficiency within the NHS.
• 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.