Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X‑ray reporting service within the NHS in England: a systematic literature review

Journal article


Lockwood, P., Burton, C., Woznitza, N. and Shaw, T. 2023. Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X‑ray reporting service within the NHS in England: a systematic literature review. BMC Health Services Research. 23 (1270), pp. 1-41. https://doi.org/10.1186/s12913-023-10161-y
AuthorsLockwood, P., Burton, C., Woznitza, N. and Shaw, T.
Abstract

Introduction
The United Kingdom (UK) government’s healthcare policy in the early 1990s paved the way adoption
of the skills mix development and implementation of diagnostic radiographers’ X-ray reporting service. Current
clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient
imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study
aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation
of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS)
in England.

Methods
Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL,
and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database;
Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS
depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995–2022 was applied. The literature
was assessed against Joanna Briggs Institute’s critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised
into subgroups of enablers and barriers.
Results The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation,
which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture,
environment, and leadership.

Conclusion
The literature since 1995 has reframed the debates on implementation of the radiographer reporting
role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional
body) and macro-level (governmental/health service) policies and guidance, that have shaped change
at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This
has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services.

KeywordsDiagnostic radiographer; Reporting radiographer; X-rays; Musculoskeletal; Implementation; Enabler; Barrier
Year2023
JournalBMC Health Services Research
Journal citation23 (1270), pp. 1-41
PublisherSpringer Nature
ISSN472-6963
Digital Object Identifier (DOI)https://doi.org/10.1186/s12913-023-10161-y
Official URLhttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-023-10161-y
FunderHealth Education England, NHS Employers
Publication dates
Print16 Nov 2023
Publication process dates
Accepted16 Oct 2023
Deposited20 Nov 2023
Publisher's version
License
File Access Level
Open
Output statusPublished
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Woznitza, N., Nair, A. and Hare, S. S. 2020. COVID-19: A case series to support radiographer preliminary clinical evaluation. Radiography. https://doi.org/10.1016/j.radi.2020.04.002
Delivery of a preliminary clinical evaluation web based short course in Finland
Pittock, L. and Woznitza, N. 2019. Delivery of a preliminary clinical evaluation web based short course in Finland.
Multi-professional image interpretation: performance in preliminary clinical evaluation of appendicular radiographs
Lockwood, P. and Pittock, L. 2019. Multi-professional image interpretation: performance in preliminary clinical evaluation of appendicular radiographs. Radiography. https://doi.org/10.1016/j.radi.2019.04.013
Impact of radiographer immediate reporting of chest x-rays from general practice on the lung cancer pathway (radioX)
Woznitza, N., Devaraj, A., Janes, S., Duffy, S., Rowe, S., Bhowmik, A., Maughn, S., Piper, K. and Baldwin, D. 2019. Impact of radiographer immediate reporting of chest x-rays from general practice on the lung cancer pathway (radioX).
Implementation, impact and costs of policies for safe staffing in acute NHS trusts
Ball, J., Barker, H., Burton, C., Crouch, R., Griffith, P., Jones, J. and Rycroft Malone, J. 2019. Implementation, impact and costs of policies for safe staffing in acute NHS trusts. University of Southampton. https://doi.org/10.5258/SOTON/P0012
Greater than the sum of the parts: Impact of radiographer clinical image interpretation
Rowe, Susan, O'Riordan, Paul and Woznitza, Nick 2019. Greater than the sum of the parts: Impact of radiographer clinical image interpretation. Journal of Medical Radiation Sciences. 66 (3), pp. 149-151. https://doi.org/10.1002/jmrs.342
Sleep hygiene education and children with developmental disabilities: Findings from a co-design study
Sutton, J.E., Huws, J.C. and Burton, C. 2019. Sleep hygiene education and children with developmental disabilities: Findings from a co-design study. Journal of Intellectual Disabilities. https://doi.org/10.1177/1744629518818950
Towards safe nurse staffing in England’s National Health Service: progress and pitfalls of policy evolution
Lawless, J., Couch, R., Griffiths, P., Burton, C. and Ball, J. 2019. Towards safe nurse staffing in England’s National Health Service: progress and pitfalls of policy evolution. Health Policy. 123 (6), pp. 590-594. https://doi.org/10.1016/j.healthpol.2019.03.011
Brief smoking cessation in acute Welsh hospitals: A realist approach
Davies, S., Burton, C., Williams, L. and Tinkler, A. 2019. Brief smoking cessation in acute Welsh hospitals: A realist approach. Health Promotion International. 35 (2), pp. 244-254. https://doi.org/10.1093/heapro/daz020
Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence
Burton, C., Williams, L., Bucknall, T., Edwards, S., Fisher, D., Hall, B., Harris, G., Jones, P., Makin, M., McBride, A., Meacock, R., Parkinson, J., Rycroft-Malone, J. and Waring, J. 2019. Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence. Systematic Reviews. 8 (194). https://doi.org/doi.org10.1186/s13643-019-1111-8
Computed tomography head and facial bones review of a 2,700 year old Egyptian mummy
Lockwood, P., Elliott, J., Nelson, A. and Harris, S. 2019. Computed tomography head and facial bones review of a 2,700 year old Egyptian mummy . BJR Case Reports. https://doi.org/10.1259/bjrcr.20190076
Visual function assessment of diagnostic radiography students
Lockwood, P. and Blackman, A. 2019. Visual function assessment of diagnostic radiography students. Radiography. https://doi.org/10.1016/j.radi.2019.10.012
Targeted active screening for tuberculosis in Zimbabwe: are field digital chest X-ray ratings reliable?
Timire, C, Sandy, C., Ngwenya, M., Woznitza, N., Kumar, A. M. V., Takarinda, K. C., Sengai, T. and Harries, A. D. 2019. Targeted active screening for tuberculosis in Zimbabwe: are field digital chest X-ray ratings reliable? Public Health Action. 9 (3), pp. 96-101. https://doi.org/10.5588/pha.19.0003
An evaluation of CT head reporting radiographers' scope of practice within the United Kingdom
Lockwood, P. 2019. An evaluation of CT head reporting radiographers' scope of practice within the United Kingdom. Radiography. 26 (2), pp. 102-109. https://doi.org/10.1016/j.radi.2019.09.001
Radiographer reporting of neurological magnetic resonance imaging examinations of the head and cervical spine: findings of an accredited postgraduate programme
Piper, K., Pittock, L. and Woznitza, N. 2018. Radiographer reporting of neurological magnetic resonance imaging examinations of the head and cervical spine: findings of an accredited postgraduate programme. Radiography. https://doi.org/10.1016/j.radi.2018.05.006
Image Interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module
Lockwood, P. and Dolbear, G. 2018. Image Interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module. Radiography. https://doi.org/10.1016/j.radi.2018.05.009
Evaluation of an equilibrium phase free-breathing dynamic contrast-enhanced MRI prototype sequence compared to traditional breath-held MRI acquisition in liver oncology patients
Hopkinson, G., Lockwood, P. and Dolbear, G. 2018. Evaluation of an equilibrium phase free-breathing dynamic contrast-enhanced MRI prototype sequence compared to traditional breath-held MRI acquisition in liver oncology patients. Radiography. https://doi.org/10.1016/j.radi.2018.01.001
NHS managers’ use of nursing workforce planning and deployment technologies: a realist synthesis
Burton, C., Rycroft-Malone, J., Williams, L., Davies, S., McBride, A., Hall, B., Rowlands, A., Jones, A., Fisher, D., Jones, M. and Caulfield, M. 2018. NHS managers’ use of nursing workforce planning and deployment technologies: a realist synthesis. Health Services and Delivery Research. 6 (36). https://doi.org/10.3310/hsdr06360
The generation of consensus guidelines for carrying out process evaluations in rehabilitation research
Masterson-Algar, P., Burton, C. and Rycroft-Malone, J. 2018. The generation of consensus guidelines for carrying out process evaluations in rehabilitation research. BMC Medical Research Methodology. 18 (1), pp. 1-11. https://doi.org/10.1186/s12874-018-0647-y
Getting back to life after stroke: co-designing a peer-led coaching intervention to enable stroke survivors to rebuild a meaningful life after stroke
Masterson-Algar, P., Williams, S., Burton, C., Arthur, C., Hoare, Z., Morrison, V., Radford, K., Seddon, D. and Elghenzai, S. 2018. Getting back to life after stroke: co-designing a peer-led coaching intervention to enable stroke survivors to rebuild a meaningful life after stroke. Disability and Rehabilitation. 42 (10), pp. 1359-1372.
Arts-based palliative care training, education and staff development: A scoping review
Turton, B.M., Williams, S., Burton, C.R. and Williams, L. 2018. Arts-based palliative care training, education and staff development: A scoping review. Palliative Medicine. 32 (2). https://doi.org/10.1177/0269216317712189
Increasing radiology capacity within the lung cancer pathway: centralised work‐based support for trainee chest X‐ray reporting radiographers
Woznitza, N., Steele, R., Piper, K., Burke, S., Rowe, S., Bhowmik, A., Maughn, S. and Springett, K. 2018. Increasing radiology capacity within the lung cancer pathway: centralised work‐based support for trainee chest X‐ray reporting radiographers. Journal of Medical Radiation Sciences. 65 (3), pp. 200-208. https://doi.org/10.1002/jmrs.285
Nuclear medicine image interpretation by radiographers: findings of an accredited postgraduate module
Lockwood, P. and Dolbear, G. 2018. Nuclear medicine image interpretation by radiographers: findings of an accredited postgraduate module. Radiography. https://doi.org/10.1016/j.radi.2018.11.007
Is a nurse consultant impact toolkit relevant and transferable to the radiography profession? An evaluation project
Snaith, B., Williams, S., Taylor, K., Tsang, Y., Kelly, J. and Woznitza, N. 2018. Is a nurse consultant impact toolkit relevant and transferable to the radiography profession? An evaluation project. Radiography. https://doi.org/10.1016/j.radi.2018.05.001
Chest X-ray interpretation by Radiographers is not inferior to Radiologists: a multireader, multicase comparison using JAFROC (Jack-knife alternative free-response receiver operating characteristics) analysis
Woznitza, N., Piper, K., Burke, S. and Bothamley, G. 2018. Chest X-ray interpretation by Radiographers is not inferior to Radiologists: a multireader, multicase comparison using JAFROC (Jack-knife alternative free-response receiver operating characteristics) analysis. Academic Radiology.
Agreement between expert thoracic radiologists and the chest radiograph reports provided by consultant radiologists and reporting radiographers in clinical practice: review of a single clinical site
Woznitza, N., Piper, K., Burke, S., Ellis, S. and Bothamley, G. 2018. Agreement between expert thoracic radiologists and the chest radiograph reports provided by consultant radiologists and reporting radiographers in clinical practice: review of a single clinical site. Radiography. https://doi.org/10.1016/j.radi.2018.01.009
Digital training platform for interpreting radiographic images of the chest
McLauchlin, L., Woznitza, N., Cairns, A., McFadden, S., Bond, R., Hughes, C., Elsayed, A., Finlay, D. and McConnell, J. 2018. Digital training platform for interpreting radiographic images of the chest. Radiography. 24 (2), pp. 159-164. https://doi.org/10.1016/j.radi.2017.12.010
Immediate reporting of chest X-rays referred from general practice by reporting radiographers: a single centre feasibility study
Woznitza, N., Piper, K., Rowe, S. and Bhowmik, A. 2017. Immediate reporting of chest X-rays referred from general practice by reporting radiographers: a single centre feasibility study. Clinical Radiology. https://doi.org/10.1016/j.crad.2017.11.016
Twitter journal clubs and continuing professional development: An analysis of a #MedRadJClub tweet chat
Bolderston, A., Watson, J., Woznitza, N., Westerink, A., Di Prospero, L., Currie, G., Beardmore, C. and Hewis, J. 2017. Twitter journal clubs and continuing professional development: An analysis of a #MedRadJClub tweet chat. Radiography. 24 (1), pp. 3-8. https://doi.org/10.1016/j.radi.2017.09.005
Becoming a clinical radiographer: role, role development and specialisation
Woznitza, N. 2017. Becoming a clinical radiographer: role, role development and specialisation.
Radiographer reporting of magnetic resonance imaging breast examinations: findings of an accredited postgraduate programme
Pittock, L., Piper, K. and Woznitza, N. 2017. Radiographer reporting of magnetic resonance imaging breast examinations: findings of an accredited postgraduate programme.
The PD COMM trial: a protocol for the process evaluation of a randomised trial assessing the effectiveness of two types of SLT for people with Parkinson's disease.
Masterson-Algar, P, Burton, C., Brady, M.C., Nicoll, A., Clarke, C.E., Rick, C., Hughes, M., Au, P., Smith, C.H. and Sackley, C.M. 2017. The PD COMM trial: a protocol for the process evaluation of a randomised trial assessing the effectiveness of two types of SLT for people with Parkinson's disease. Trials. 18 (397), p. 2017. https://doi.org/10.1186/s13063-017-2130-1
Managing diabetes in people with dementia: a realist review
Bunn, F., Goodman, C., Jones, P.R., Russell, B., Trivedi, D., Sinclair, A., Bayer, A., Rait, G., Rycroft-Malone, J. and Burton, C. 2017. Managing diabetes in people with dementia: a realist review. Perth, Scotland NIHR Journals Library. https://doi.org/10.3310/hta21750
Implementation and trial evidence: a plea for fore-thought
Brocklehurst, P.R., Williams, L., Burton, C., Goodwin, T. and Rycroft-Malone, J. 2017. Implementation and trial evidence: a plea for fore-thought. British Dental Journal. 222 (5), pp. 331-335. https://doi.org/10.1038/sj.bdj.2017.213
What works for whom in the management of diabetes in people living with dementia: a realist review
Bunn, F., Goodman, C., Jones, P. R., Russell, B., Trivedi, D., Sinclair, A., Bayer, A., Rait, G., Rycroft-Malone, J. and Burton, C. 2017. What works for whom in the management of diabetes in people living with dementia: a realist review. BMC Medicine. 15 (141). https://doi.org/10.1186/s12916-017-0909-2
Impact of radiographer immediate reporting of chest X-rays from general practice on the lung cancer pathway (radioX): study protocol for a randomised control trial
Woznitza, N., Devaraj, A., Janes, S., Duffy, S., Bhowmik, A., Rowe, S., Piper, K., Maughn, S. and Baldwin, D. 2017. Impact of radiographer immediate reporting of chest X-rays from general practice on the lung cancer pathway (radioX): study protocol for a randomised control trial. Trials. 18 (521). https://doi.org/10.1186/s13063-017-2268-x
Expanding the role of radiographers in reporting suspected lung cancer: a cost-effectiveness analysis using a decision tree model
Bajre, M., Pennington, M., Woznitza, N., Beardmore, C., Radhakrishnan, M., Harris, R. and Mccrone, P. 2017. Expanding the role of radiographers in reporting suspected lung cancer: a cost-effectiveness analysis using a decision tree model. Radiography. 23 (4), pp. 273-278. https://doi.org/10.1016/j.radi.2017.07.011
CT Sinus and facial bones reporting by radiographers: findings of an accredited postgraduate programme
Lockwood, P. 2017. CT Sinus and facial bones reporting by radiographers: findings of an accredited postgraduate programme. Dentomaxillofacial Radiology. 46 (4). https://doi.org/10.1259/dmfr.20160440
Exploring variation and trends in adherence to national occupational standards for reporting radiographers
Lockwood, P. 2017. Exploring variation and trends in adherence to national occupational standards for reporting radiographers. Journal of Social Science & Allied Health Professions. 1 (1), pp. 20-27.
Twitter journal club in medical radiation science
Currie, G., Woznitza, N., Bolderston, A., Weserink, A., Watson, J., Beardmore, C., Di Prospero, L., McCuig, C. and Nightingale, J. 2017. Twitter journal club in medical radiation science. Journal of Medical Imaging and Radiation Sciences. 48 (1), pp. 83-89. https://doi.org/10.1016/j.jmir.2016.09.001
Observer performance in Computed Tomography head reporting
Lockwood, P. 2017. Observer performance in Computed Tomography head reporting. Journal of Medical Imaging and Radiation Sciences. 48 (1), pp. 22-29. https://doi.org/10.1016/j.jmir.2016.08.001
Optimisation de la prise en charge en Rafiologie: Approts des manipulateurs experts interprétant des examens: Cas pratique au Royaume Uni
Woznitza, N., Piper, K., West, C. and Rowe, S. 2014. Optimisation de la prise en charge en Rafiologie: Approts des manipulateurs experts interprétant des examens: Cas pratique au Royaume Uni.
Chest x-ray agreement: comparative analysis between consultant radiologists, reporting radiographers and expert chest radiologists
Woznitza, N., Piper, K., Burke, S., Ellis, S. and Bothamley, G. 2015. Chest x-ray agreement: comparative analysis between consultant radiologists, reporting radiographers and expert chest radiologists.
Team working in radiology: optimising care
Woznitza, N. 2016. Team working in radiology: optimising care.
Advanced practice in diagnostic imaging
Woznitza, N. 2016. Advanced practice in diagnostic imaging.
Team working in radiology: what is possible?
Woznitza, N., Piper, K., Ratcliff, C., McGuinness, N. and Rowe, S. 2016. Team working in radiology: what is possible?
The Twitter Journal Club for Medical Radiation Professionals (#medradjclub): CPD/CE for the 21st century
Currie, G., Woznitza, N., Bolderston, A., Westerink, A., Waton, J., Beardmore, C., Di Prospero, L., McCuaig, C. and Nightingale, J. 2016. The Twitter Journal Club for Medical Radiation Professionals (#medradjclub): CPD/CE for the 21st century.
Bloom’s taxonomy of Twitter: higher order thinking and the Twitter Journal Club
Currie, G., Woznitza, N., Bolderston, A., Westerink, A., Watson, J., Beardmore, C., Di Prospero, L., McCuaig, C. and Nightingale, J. 2016. Bloom’s taxonomy of Twitter: higher order thinking and the Twitter Journal Club. Society of Nuclear Medicine and Molecular Imaging.
Chest x-ray interpretation by radiographers: diagnostic accuracy and influence on diagnostic reasoning
Woznitza, N., Piper, K., Burke, S. and Bothamley, G. 2016. Chest x-ray interpretation by radiographers: diagnostic accuracy and influence on diagnostic reasoning.
Diagnostic accuracy of radiographer chest x-ray reporting
Woznitza, N., Piper, K., Burke, S. and Bothamley, G. 2016. Diagnostic accuracy of radiographer chest x-ray reporting.
Exploring the benefits of magnetic resonance imaging reporting by radiographers: A UK perspective
Lockwood, P. 2016. Exploring the benefits of magnetic resonance imaging reporting by radiographers: A UK perspective. Journal of Medical Imaging and Radiation Sciences. 47 (2). https://doi.org/10.1016/j.jmir.2015.12.083
Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions
Rycroft-Malone, J., Burton, C., Williams, L., Edwards, S., Fisher, D., Hall, B., McCormack, B., Nutley, S., Seddon, D. and Williams, R. 2016. Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions. National Institute of Health Research. https://doi.org/10.3310/hsdr04120
Implementing a Systematic Voiding Program for Patients With Urinary Incontinence After Stroke
French, B., Thomas, L.H., Harrison, J., Burton, C., Forshaw, D., Booth, J., Britt, D., Cheater, F.M., Roe, B. and Watkins, C.L. 2016. Implementing a Systematic Voiding Program for Patients With Urinary Incontinence After Stroke. Qualitative Health Research. 26 (10). https://doi.org/10.1177/1049732316630975
Implementing best practice in infection prevention and control. A realist evaluation of the role of intermediaries
Williams, L., Rycroft-Malone, J. and Burton, C. 2016. Implementing best practice in infection prevention and control. A realist evaluation of the role of intermediaries. International Journal of Nursing Studies. 60, pp. 156-167. https://doi.org/10.1016/j.ijnurstu.2016.04.012
Bringing critical realism to nursing practice: Roy Bhaskar's contribution
Williams, L., Rycroft-Malone, J. and Burton, C. 2016. Bringing critical realism to nursing practice: Roy Bhaskar's contribution. nursing philosophy: an international journal for healthcare professionals. 18 (2). https://doi.org/10.1111/nup.12130
Managers' use of nursing workforce planning and deployment technologies: protocol for a realist synthesis of implementation and impact
Burton, C., Rycroft-Malone, J., Williams, L., Davies, S., McBride, A., Hall, B., Rowlands, A.M. and Jones, A. 2016. Managers' use of nursing workforce planning and deployment technologies: protocol for a realist synthesis of implementation and impact. BMJ Open. 6 (8). https://doi.org/10.1136/bmjopen-2016-013645
Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions
Williams, L., Rycroft-Malone, J., Burton, C., Edwards,S., Fisher, D., Hall, B., McCormack, B., Nutley, S.M., Seddon, D. and Williams, R. 2016. Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions. BMJ Open. 6 (8). https://doi.org/10.1136/bmjopen-2016-011964
Strategies to prevent oral disease in dependent older people
Brocklehurst, P., Williams, L., Hoare, Z., Goodwin, T., McKenna, G., Tsakos, G., Chestnutt, I.G., Pretty, I., Wassall, R., Jerkovic-Cosic, K., Hayes, M., Watt, R.G. and Burton, C. 2016. Strategies to prevent oral disease in dependent older people. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD012402
Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research
Masterson-Algar, P., Burton, C. and Rycroft-Malone, J. 2016. Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research. BMJ Open. 6 (11). https://doi.org/10.1136/bmjopen-2016-013002
Managing diabetes in people with dementia: protocol for a realist review
Bunn, F., Goodman, C., Rycroft Malone, J., Reece Jones, P., Burton, C., Rait, G., Trivedi, D., Bayer, A. and Sinclair, A. 2016. Managing diabetes in people with dementia: protocol for a realist review. Systematic Reviews. 5 (5). https://doi.org/10.1186/s13643-015-0182-4
Collaboration and co-production knowledge in healthcare: opportunities and challenges
Rycroft-Malone, J., Burton, C.R., Bucknall , T., Graham, I.D., Hutchinson, A. and Stacey, D. 2016. Collaboration and co-production knowledge in healthcare: opportunities and challenges. International Journal of Health Policy and Management. 5 (4), pp. 221-223. https://doi.org/10.15171/IJHPM.2016.08
Collective action for implementation: a realist evaluation of organisational collaboration in healthcare
Rycroft-Malone, J., Burton, C.R., Wilkinson, J., Harvey, G., McCormack, B., Baker, R., Dopson, S., Graham, I.D., Staniszewska, S., Thompson, C., Ariss, S., Melville-Richards, L. and Williams , L. 2016. Collective action for implementation: a realist evaluation of organisational collaboration in healthcare. Implementation Science : IS. 11 (17). https://doi.org/10.1186/s13012-016-0380-z
An occupational therapy intervention for residents with stroke-related disabilities in UK care homes (OTCH): cluster randomised controlled trial with economic evaluation
Sackley, C.M., Walker, M.F., Burton, C.R., Watkins,C.L, Mant, J., Roalfe, A.K., Wheatley, K., Sheehan, B., Sharp, L., Stant, K.E., Fletcher-Smith, J., Steel, K., Barton, G.R., Irvine, L. and Peryer, G. 2016. An occupational therapy intervention for residents with stroke-related disabilities in UK care homes (OTCH): cluster randomised controlled trial with economic evaluation. Health Technology Assessment. 20 (15). https://doi.org/10.3310/hta20150
The diagnostic accuracy of reporting radiographer chest x-ray interpretations and their influence on clinicians’ diagnostic decision-making: a comparison with consultant radiologists
Woznitza, N. 2016. The diagnostic accuracy of reporting radiographer chest x-ray interpretations and their influence on clinicians’ diagnostic decision-making: a comparison with consultant radiologists. PhD Thesis Canterbury Christ Church University School of Allied Health Professions
The radiography workforce: current challenges and changing needs
Beardmore, C., Woznitza, N., Goodman, S. and Society & College of Radiographers 2016. The radiography workforce: current challenges and changing needs. College of Radiographers.
An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice.
Lockwood, P. 2016. An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice. Radiography. https://doi.org/10.1016/j.radi.2015.09.004
Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study
Lockwood, P., Pittock, L., Lockwood, C., Jeffery, C. and Piper, K. 2015. Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study. Radiography. 2015, pp. 1-5. https://doi.org/10.1016/j.radi.2015.06.005
Out of the comfort zone (Part 2)
Lockwood, P. 2013. Out of the comfort zone (Part 2).
AFROC analysis of reporting radiographer’s performance in CT head interpretation
Lockwood, P. and Piper, K. 2015. AFROC analysis of reporting radiographer’s performance in CT head interpretation. Radiography. 21 (3), pp. e90-e95. https://doi.org/10.1016/j.radi.2015.04.001
Out of the comfort zone (Part 1)
Lockwood, P. 2013. Out of the comfort zone (Part 1).
Origins of the Reporting Radiographer
Lockwood, P. 2013. Origins of the Reporting Radiographer.
Patient safety and quality improvement: Iatrogenic venous air embolism in diagnostic imaging
Lockwood, P. and Breen, W. 2013. Patient safety and quality improvement: Iatrogenic venous air embolism in diagnostic imaging.
CT head reporting by radiographers: Findings of an accredited postgraduate programme
Lockwood, P. and Piper, K. 2013. CT head reporting by radiographers: Findings of an accredited postgraduate programme.
CT skull base & calvarium normal variant pitfalls
Lockwood, P. 2013. CT skull base & calvarium normal variant pitfalls.
Chest reporting by radiographers: Findings of an accredited postgraduate programme.
Piper, K., Cox, S., Paterson, A., Thomas, A., Thomas, N., Jeyagopal, N. and Woznitza, N. 2014. Chest reporting by radiographers: Findings of an accredited postgraduate programme. Radiography. 20 (2), pp. 94-99. https://doi.org/10.1016/j.radi.2014.01.003
Adult chest radiograph reporting by radiographers: Preliminary data from an in-house audit programme
Woznitza, N., Piper, K., Burke, S., Patel, K., Amin, S., Grayson, K. and Bothamley, G. 2014. Adult chest radiograph reporting by radiographers: Preliminary data from an in-house audit programme. Radiography. 20 (3), pp. 223-229. https://doi.org/10.1016/j.radi.2014.03.002
Optimizing patient care in radiology through team-working: A case study
Woznitza, N., Piper, K., Rowe, S. and West, C. 2014. Optimizing patient care in radiology through team-working: A case study. Radiography. 20 (3), pp. 258-263. https://doi.org/10.1016/j.radi.2014.02.007
Identifying Continence OptioNs after Stroke (ICONS): an evidence synthesis, case study and exploratory cluster randomised controlled trial of the introduction of a systematic voiding programme for patients with urinary incontinence after stroke in secondary care
Thomas, L. H., French, B., Sutton, C. J., Forshaw, D., Leathley, M. J., Burton, C., Roe, B., Cheater, F. M., Booth, J., McColl, E., Carter, B., Walker, A., Brittain, K., Whiteley, G., Rodgers, H., Barrett, J. and Watkins, C. L. 2015. Identifying Continence OptioNs after Stroke (ICONS): an evidence synthesis, case study and exploratory cluster randomised controlled trial of the introduction of a systematic voiding programme for patients with urinary incontinence after stroke in secondary care. NIHR Journals Library.
Collective action for knowledge mobilisation: a realist evaluation of the collaborations for leadership in applied health research and care
Rycroft-Malone, J., Burton, C., Wilkinson, J., Harvey, G., McCormack, B., Baker, R., Dopson, S., Graham, I., Staniszewska, S., Thompson, C., Ariss, S., Melville-Richards, L. and Williams, L. 2015. Collective action for knowledge mobilisation: a realist evaluation of the collaborations for leadership in applied health research and care. UK NIHR Journals Library. https://doi.org/10.3310/hsdr03440
An untapped resource: patient and public involvement in implementation comment on "Knowledge mobilization in healthcare organizations": a view from the resource-based view of the firm
Burton, C. and Rycroft-Malone, J. 2015. An untapped resource: patient and public involvement in implementation comment on "Knowledge mobilization in healthcare organizations": a view from the resource-based view of the firm. International Journal of Health Policy and Management. 4 (12), pp. 845-847. https://doi.org/10.15171/ijhpm.2015.150
Conceptualisation of the characteristics of advanced practitioners in the medical radiation profession
Smith, Tony, Harris, J., Woznitza, N., Marese, S. and Sale, C. 2015. Conceptualisation of the characteristics of advanced practitioners in the medical radiation profession. Journal of Medical Radiation Sciences. 62 (3), pp. 204-211. https://doi.org/10.1002/jmrs.115
CT head reporting by radiographers: results of an accredited postgraduate programme
Lockwood, P., Piper, K. and Pittock, L. 2015. CT head reporting by radiographers: results of an accredited postgraduate programme. Radiography. 21 (3), pp. e85-e89. https://doi.org/10.1016/j.radi.2014.12.001
e-Learning for Healthcare – Image Interpretation Project
Woznitza, N., e-Learning for Healthcare and College of Radiographers 2012. e-Learning for Healthcare – Image Interpretation Project. e-Learning for Healthcare.
An unusual cause of respiratory distress
Woznitza, N., Datsopolous, S., Shukla, R. and Aladangady, N. 2012. An unusual cause of respiratory distress. Archives of Disease in Childhood. 97, pp. A12-A13. https://doi.org/10.1136/archdischild-2012-301885.30
Chest X-Ray interpretation: agreement between consultant radiologists and a reporting radiographer in clinical practice in the United Kingdom
Woznitza, N., Piper, K., Burke, S., Patel, K., Amin, S. and Grayson, K. 2013. Chest X-Ray interpretation: agreement between consultant radiologists and a reporting radiographer in clinical practice in the United Kingdom.
Radiographer clinical reporting
Woznitza, N. 2014. Radiographer clinical reporting.
Commentary: radiographer reporting
Woznitza, N. 2014. Commentary: radiographer reporting. Journal of Medical Radiation Sciences. 61 (2), pp. 66-68. https://doi.org/10.1002/jmrs.51
Do you see what I see? Clinical review of discordant chest x-ray consultant radiologist and radiographer interpretations
Woznitza, N., Piper, K., Bothamley, G. and Burke, S. 2014. Do you see what I see? Clinical review of discordant chest x-ray consultant radiologist and radiographer interpretations.
Optimizing patient care in radiology through team-working: audit data
Woznitza, N. 2014. Optimizing patient care in radiology through team-working: audit data.
Optimizing neonatal X-ray quality: results of an audit
Woznitza, N., Hayes, N., Malshava, N. and McGuinness, D. 2014. Optimizing neonatal X-ray quality: results of an audit.
Agreement in neonatal x-ray interpretation: a comparison between consultant paediatric radiologists and a reporting radiographer
Woznitza, N., Piper, K., Aladangady, N., Iliadis, K., Prakash, R. and Santos, R. 2014. Agreement in neonatal x-ray interpretation: a comparison between consultant paediatric radiologists and a reporting radiographer.
Advanced radiographic practice in adult chest imaging
Woznitza, N. 2014. Advanced radiographic practice in adult chest imaging.
Investigating preferences for support with life after stroke: a discrete choice experiment
Burton, C., Fargher, E., Plumpton, C., Roberts, G.W, Owen, H. and Roberts, E. 2014. Investigating preferences for support with life after stroke: a discrete choice experiment. BMC Health Services Research. 14 (63). https://doi.org/10.1186/1472-6963-14-63
Evaluating a systematic voiding programme for patients with urinary incontinence after stroke in secondary care using soft systems analysis and Normalisation Process Theory: findings from the ICONS case study phase.International journal of nursing studies
Thomas, L.H, French, B., Burton, C., Sutton, C., Forshaw, D., Dickinson, H., Leathley, M.J., Britt, D., Roe, B., Cheater, F.M, Booth, J., Watkins, C.L, ICONS Project Team, ICONS Patient and Public and Carer Involvement Groups 2014. Evaluating a systematic voiding programme for patients with urinary incontinence after stroke in secondary care using soft systems analysis and Normalisation Process Theory: findings from the ICONS case study phase.International journal of nursing studies. International Journal of Nursing Studies. 51 (10), pp. 1308-1320. https://doi.org/10.1016/j.ijnurstu.2014.02.009
Improving skills and care standards in the support workforce for older people: a realist review
Rycroft-Malone, J., Burton, C., Hall, B., McCormack, B., Nutley, S., Seddon, D. and Williams, L. 2014. Improving skills and care standards in the support workforce for older people: a realist review. BMJ Open. 4 (5). https://doi.org/10.1136/bmjopen-2014-005356
Does self-efficacy influence recovery and well-being in osteoarthritis patients undergoing joint replacement? A systematic review
Magklara, E., Burton, C. and Morrison, V. 2014. Does self-efficacy influence recovery and well-being in osteoarthritis patients undergoing joint replacement? A systematic review. Clinical Rehabilitation. 28 (9). https://doi.org/10.1177/0269215514527843
Towards a programme theory for fidelity in the evaluation of complex interventions.
Masterson-Algar, P., Burton, C., Rycroft-Malone, J., Sackley, C.M. and Walker, M.F. 2014. Towards a programme theory for fidelity in the evaluation of complex interventions. Journal of Evaluation in Clinical Practice . 20 (4), pp. 445 - 452. https://doi.org/10.1111/jep.12174
Investigating the organisational impacts of quality improvement: a protocol for a realist evaluation of improvement approaches drawing on the Resource Based View of the Firm.
Burton, C., Rycroft Malone, J., Robert, G., Willson, A. and Hopkins, A. 2014. Investigating the organisational impacts of quality improvement: a protocol for a realist evaluation of improvement approaches drawing on the Resource Based View of the Firm. BMJ Open. 4:e005650. https://doi.org/10.1136/bmjopen-2014-005650
Resource based view of the firm as a theoretical lens on the organisational consequences of quality improvement.
Burton, C. and Rycroft-Malone, J. 2014. Resource based view of the firm as a theoretical lens on the organisational consequences of quality improvement. International Journal of Health Policy and Management. 3 (3), pp. 113 - 115. https://doi.org/10.15171/ijhpm.2014.74
The study protocol of: 'Initiating end of life care in stroke: clinical decision-making around prognosis'.
Burton, C., Payne, S., Turner, M., Bucknall, T., Rycroft-Malone, J., Tyrell, P., Horne, M., Ntambwe, L.I., Tyson, S., Mitchell, H., Williams, S. and Elghenzai, S. 2014. The study protocol of: 'Initiating end of life care in stroke: clinical decision-making around prognosis'. BMC Palliative Care. 13 (55). https://doi.org/10.1186/1472-684X-13-55
Identifying continence options after stroke (ICONS): a cluster randomised controlled feasibility trial.
Thomas, L.H., Watkins, C.L., Sutton, C.J., Forshaw, D., Leathley, M.J., French, B., Burton, C., Cheater, F., Roe, B., Britt, D., Booth, J., McColl, E., The ICONS Project Team and The ICONS Patient, Public and Carer Involvement Groups 2014. Identifying continence options after stroke (ICONS): a cluster randomised controlled feasibility trial. Trials. 15 (509). https://doi.org/10.1186/1745-6215-15-509
What is rehabilitation potential? Development of a theoretical model through the accounts of healthcare professionals working in stroke rehabilitation services
Burton, C.R., Horne, M., Woodward-Nutt, K., Bowen, A. and Tyrrell, P. 2014. What is rehabilitation potential? Development of a theoretical model through the accounts of healthcare professionals working in stroke rehabilitation services. Disability and Rehabilitation. 37 (21), pp. 1955-1960. https://doi.org/10.3109/09638288.2014.991454
Can reporting radiographers produce clinically relevant reports?
Woznitza, N. and Piper, K. 2011. Can reporting radiographers produce clinically relevant reports?