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Is this the next evolutionary step?
Radiographers' roles within emergency departments (ED) in the United Kingdom (UK) have historically been restricted to image acquisition. Over the past 20 years, this has evolved to roles such as image interpretation and red dot schemes which are considered examples of skill-mix; these aim to remove barriers within the National Health Service (NHS) to benefit the patient1. Skill-mix extensions have become fundamental to current practice and have blurred professional boundaries2; allowing for further role extensions to emerge such as radiographer-led discharge (RLD) within the ED.
This review article explores various studies that have been carried out into RLD. It aims to discuss the potential impact this role could have upon the quality of ED services and professional practice, and also examine the potential barriers/disadvantages of implementing this service.
A search of relevant literature was conducted using the scientific database Science Direct, and comprises of articles from peer-reviewed journals such as Radiography. Inclusion criteria was literature from the year 2000 onwards, originating from the UK however, literature from White and McKay3, who are Hong Kong based, was also reviewed. This was included as its content is aimed towards radiographer practice within the UK.
BACKGROUND/CONTEXT
Radiographer role extension has continually grown since the mid 1990s and often involves radiographers carrying out tasks formerly the responsibility of other healthcare staff 4. Factors that have encouraged this include the continuous shortage of radiologists since the 1970s4 which reduced resistance to the idea of role extension, and also the increasing demands to NHS services.
Role extension accelerated in 2002 with the introduction of the Department of Health's 'four-tier service delivery model'5; 'a skill-mix model that has led to such roles as performing barium studies and image reporting being implemented. This model aimed to address issues that were arising due to these shortages and pressure from radiographers to advance their career development opportunities. It shapes a clinical team to the requirements of the patient and not to the perceived professional boundaries; the model actively encourages radiographer role extensions.
Currently patients are attended to by either a medical or nursing professional, for example an emergency nurse practitioner (ENP) within the ED, and if necessary they are referred to the imaging department to undergo diagnostic...