# Enhancing Radiology Request Form Completeness With a Standardized Tool and Targeted Education: A Two-Cycle Clinical Audit

## TL;DR

This study shows that using a standardized radiology request form and providing targeted education significantly improves the completeness of medical imaging requests in a hospital setting.

## Contribution

A two-cycle clinical audit demonstrates that a standardized form and clinician education can significantly improve radiology request form completeness in resource-limited settings.

## Key findings

- Baseline documentation of radiology request forms was critically incomplete for parameters like patient address and clinical background.
- After intervention, documentation of address, urgency, clinical background, and diagnostic questions improved significantly (p < 0.0001).
- Telephone contact information and requested imaging modality showed no significant improvement.

## Abstract

Background: Incomplete radiology request forms (RRFs) hinder diagnostic accuracy, delay patient management, and increase the risk of unnecessary imaging. This issue is particularly relevant in resource-limited healthcare settings where RRFs represent the primary communication tool between clinicians and radiology departments.

Objectives: To evaluate the completeness of RRF documentation at Bashair University Hospital and assess the impact of implementing a standardized form supported by targeted clinician education.

Methods: A prospective closed-loop clinical audit was conducted over two cycles, with 50 RRFs reviewed in each phase. Cycle 1 was performed over two weeks in May 2025, followed by a one-month intervention that introduced a structured Royal College of Radiologists (RCR)-compliant request form and delivered educational sessions. Cycle 2 was conducted over a subsequent three-month period. Data were extracted using a predefined checklist and analyzed using descriptive statistics and chi-square testing.

Results: Baseline documentation was markedly deficient across several critical parameters, including patient address 0 (0.0%), urgency 0 (0.0%), clinical background 8 (16.0%), and the stated clinical question 3 (6.0%). Following the intervention, statistically significant improvements were observed in address documentation 47 (94.0%), p < 0.0001; urgency 47 (94.0%), p < 0.0001; clinical background 42 (84.0%), p < 0.0001; and diagnostic question 41 (82.0%), p < 0.0001. Recording the referring clinician’s name also improved substantially from 9 (18.0%) to 47 (94.0%) (p < 0.0001). The patient's name was consistently documented at 50 (100.0%) in both cycles. Conversely, telephone contact information remained poorly documented (1, 2.0%, p = 1.000), and documentation of the requested imaging modality showed no statistically significant improvement (p = 0.5579).

Conclusion: The implementation of a standardized RRF and focused educational intervention substantially improved documentation quality and compliance with RCR standards. These findings demonstrate the feasibility and effectiveness of low-cost interventions in optimizing communication, enhancing diagnostic safety, and reducing unnecessary imaging. Continued monitoring, reinforcement of contact information fields, and periodic re-audits are recommended to sustain improvements.