Monday 06 May 2024
Internal Reference Number: FOI_7001
Date Request Received: 02/02/2023 00:00:00
Date Request Replied To: 08/02/2023 00:00:00
This response was sent via: By Email
Request Summary: DXA Facilities Audit
Request Category: Charities
| Question Number 1: Do you outsource your DXA scans? If Yes- please state the organisation providing this service and forward this FOI to your provider for completion (please continue to complete for any of the elements of the DXA pathway that are provided by your Trust/board) | |
| Answer To Question 1: No | |
| Question Number 2: In January 2023 how many DXA scanning machines did you have at your trust/board for clinical use? a. n. Operational b. n. not in use c. n. accessible outside of Trust | |
| Answer To Question 2: 1 scanner - operational | |
| Question Number 3: What is the average weekly capacity for clinical scans? (N. of scans per week) | |
| Answer To Question 3: 46 | |
| Question Number 4: What was your average DNA rate over the last 3 months? (n. DNA/total n. scans booked) | |
| Answer To Question 4: 5.2% | |
| Question Number 5: What age range do you include in your clinical scans? Please tick all that apply a. <20 years b. 20-40 years c. 40-60 years d. 60-75 years e. 75-80 years f. >80 years | |
| Answer To Question 5: All – over age of 17 years old | |
| Question Number 6: What is the duration of your routine DXA appointment: a. 15 minutes or less b. 16-25 minutes c. 26-30 minutes d. >30 minutes | |
| Answer To Question 6: a. 15 minutes or less | |
| Question Number 7: What was the average wait for clinical patients from referral to scan in January 2023? a. <2 weeks (move to Q9) b. 2-6 weeks (move to Q9) c. 6-13 weeks d. >13 weeks | |
| Answer To Question 7: b. 2-6 weeks (move to Q9) | |
| Question Number 8: What are your perceived barriers to delivering DXA scans within 6 weeks from referral? Please tick all that apply a. Scanner capacity (DXA equipment) b. Clinical capacity (operator) c. Other- please state | |
| Answer To Question 8: N/A | |
| Question Number 9: What was the average time from the scan to the report being available to the referrer in January 2023? a. <3 weeks (move to Q11) b. 4-6 week c. 6-13 weeks d. >13 weeks | |
| Answer To Question 9: a. <3 weeks (move to Q11) | |
| Question Number 10: What are your perceived barriers to referrers receiving DXA scan reports within 3 weeks from scan? Please tick all that apply a. Clerical- internal b. Clinical- internal c. Factors external to this service (please state) d. Other (please state) | |
| Answer To Question 10: N/A | |
| Question Number 11: What hospital department is responsible for delivery of DXA scans: a. Radiology b. Medical physics c. Nuclear medicine d. Rheumatology e. Other- please state | |
| Answer To Question 11: b – Medical Physics (in Clinical Science and Engineering Dept) | |
| Question Number 12: Which DXA examinations are included in routine protocols for the clinical service? Please tick all that apply a. Lumbar spine b. Proximal femur c. Long femur (AFF assessment) d. Total body e. Vertebral fracture assessment (VFA) f. Peripheral/forearm | |
| Answer To Question 12: a. Lumbar spine b. Proximal femur e. Vertebral fracture assessment (VFA) f. Peripheral/forearm | |
| Question Number 13: What access facilities do you have available? Please tick all that apply a. Overhead hoist b. Portable hoist c. Wheelchair transfers d. Bed/trolly transfers e. Changing room f. assistance for transfers g. Other- please state | |
| Answer To Question 13: c. Wheelchair transfers f. assistance for transfers g. Other- please state - Disable WC | |
| Question Number 14: Workforce: i) What professional groups perform DXA scan measurements at your center? (DXA operators) a. Radiographer b. DXA technician c. Assistant practitioner d. Clinical scientist e. Nurse f. Medical Dr- please state specialism g. Other- please state h. Unknown] ii) Please indicate WTE for each group selected | |
| Answer To Question 14: c. Assistant practitioner d. Clinical scientist | |
| Question Number 15: What DXA-specific training (outside of professional training) have the DXA operators performing scans had? a. In house b. Manufacturers applications training c. Recognized/accredited national training programme (please state the name of the training programme/provider) d. Other- please state e. unknown | |
| Answer To Question 15: a. In house b. Manufacturers applications training c. Recognized/accredited national training programme (please state the name of the training programme/provider) (NOS course – online + portfolio) | |
| Question Number 16: What professional groups report your DXA scans at your center? () a. Radiographer - internal b. Radiographer - external c. DXA technician – internal d. DXA technician - external e. Assistant practitioner – internal f. Assistant practitioner - external g. Clinical scientist – internal h. Clinical scientist - external i. Nurse -internal j. Nurse - external k. Medical Dr – internal - please state specialism(s) l. Medical Dr – external - please state specialism(s) m. Other- please state n. Reporting is outsourced o. unknown | |
| Answer To Question 16: g. Clinical scientist – internal | |
| Question Number 17: What training (outside of professional training) have those reporting DXA scans had- specifically in DXA reporting? a. In house b. Manufacturers applications training c. Recognized/accredited national training programme (please state the name of the training programme/provider) d. Other- please state e. unknown | |
| Answer To Question 17: b. Manufacturers applications training | |
| Question Number 18: What professional group provides clinical leadership for your service? a. Radiographer b. DXA technician c. Assistant practitioner d. Clinical scientist e. Nurse f. Medical Dr- please state specialism(s) g. Other- please state h. unknown | |
| Answer To Question 18: d. Clinical scientist f. Medical Dr- please state specialism(s) (Rheumatology) | |
| Question Number 19: Please indicate how many (WTE) clinical vacancies in your DXA service do you have in January 2023? (Free text) | |
| Answer To Question 19: 0 | |
| Question Number 20: Quality: Is your service accredited as part of a national programme? a. ISAS b. IOS c. Other- please state d. None e. Unknown | |
| Answer To Question 20: d. None | |
| Question Number 21: What clinical audits do you routinely undertake? Please tick all that apply a. DXA scan technique b. Reporting (double reporting) c. Reporting (clinical review) d. Scanner QA review e. Other- please state f. unknown | |
| Answer To Question 21: b. Reporting (double reporting) d. Scanner QA review | |
| Question Number 22: What IR(ME)R audits do you routinely undertake? Please tick all that apply a. Patient pregnancy b. DXA dose audit c. Referrer entitlement d. Scan justification e. Other- please state f. unknown | |
| Answer To Question 22: a. Patient pregnancy c. Referrer entitlement d. Scan justification | |
| Question Number 23: What clinical protocols do you have in place? Please tick all that apply a. Scan site b. Scan mode c. Reference data selection d. Patient positioning e. Scan analysis f. Interpretation- T&Z-scores g. Reporting h. Other- please state i. Unknown | |
| Answer To Question 23: a. Scan site b. Scan mode c. Reference data selection d. Patient positioning e. Scan analysis | |
| Question Number 24: Which of the following are routinely included in the DXA report issued to the PRIMARY CARE referrer? Please tick all that apply a. Admin. details i. Date of assessment ii. Patient ID and demographics iii. Reason for referral iv. Reporter’s ID b. BMD results for each measurement site i. T score (after peak bone mass) ii. Z score iii. Rate of change for serial measurements c. Comment on reliability of measurements i. BMD results ii. Documentation of excluded measurements eg vertebrae iii. Statistical significance of rate of change iv. Clinical significance of rate of change d. WHO diagnostic category (for adults after peak bone mass) e. Results of additional investigations performed at DXA appointment i. VFA ii. X-ray or other imaging iii. Laboratory tests f. Summary of clinical risk factors for fracture g. Summary of fracture history h. Clinical interpretation to quantify absolute fracture risk i. FRAX+BMD ii. FRAX + TBS iii. FRAX+BMD plus comment on additional adjustment iv. Statement on level of risk based on clinical judgement (eg low/moderate/high) i. Management advice i. Reference to national guideline (NICE/NOGG/ROS) ii. Reference to local management guideline iii. Individualised advice j. Recommendations on: i. Need for onward referral eg falls assessment or additional investigation ii. Timing of future scan | |
| Answer To Question 24: a/i,ii,iv; b/i,ii; c/i, d, e/i | |
| Question Number 25: Which of the following are routinely included in the DXA report issued to the SECONDARY CARE referrer? Please tick all that apply a. Admin. details i. Date of assessment ii. Patient ID and demographics iii. Reason for referral iv. Reporter’s ID b. BMD results for each measurement site i. T score (after peak bone mass) ii. Z score iii. Rate of change for serial measurements c. Comment on reliability of measurements i. BMD results ii. Documentation of excluded measurements eg vertebrae iii. Statistical significance of rate of change iv. Clinical significance of rate of change d. WHO diagnostic category (for adults after peak bone mass) e. Results of additional investigations performed at DXA appointment i. VFA ii. X-ray or other imaging iii. Laboratory tests f. Summary of clinical risk factors for fracture g. Summary of fracture history h. Clinical interpretation to quantify absolute fracture risk i. FRAX+BMD ii. FRAX + TBS iii. FRAX+BMD plus comment on additional adjustment iv. Statement on level of risk based on clinical judgement (eg low/moderate/high) i. Management advice i. Reference to national guideline ii. Reference to local management guideline iii. Individualised advice j. Recommendations on: i. Need for onward referral eg falls assessment or additional investigation ii. Timing of future scan k. The secondary care report is the same as the primary care report | |
| Answer To Question 25: k. The secondary care report is the same as the primary care report | |
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