Ongoing difficulties with referral processes indicate a need to develop and implement effective referral system-strengthening interventions.
All intervention centres struggled to implement working referral structures for lifestyle promotion, a resource that could have facilitated referral practice further.
The ACR thinks that radiologists can implement imaging referral guidelines in clinical practice by taking away any economical bias, the guidelines should be reviewed permanently by peers, and self-regulation and formal adhesion should be achieved by strengthening education.
In many regions of the world, the situation is different and quite diverse, depending on the specific features of health care systems in different countries, but there are, unlike in the USA and EU, no legal obligations to implement imaging referral guidelines into the clinical practice.
All intervention centres struggled to implement working referral structures for lifestyle promotion.
All intervention centres had implemented multi-professional teams, appointed team managers and held regular meetings but struggled to implement a referral structure that was used consistently among staff.
In addition, intervention centres struggled to implement a referral structure that was used consistently among staff, which could have reduced opportunities for coordinated care.
Furthermore, ETDZ and Shangcai officially implement a "referral model", by referring patients who need more complex treatment and care to designated higher-level hospitals (either at the county- or municipal-level).
Jiwa, M. et al. Implementing referral guidelines: lessons from a negative outcome cluster randomised factorial trial in general practice.
Our study highlights the challenges faced by clinicians in implementing the referral guidelines, which may result in inappropriate referral, and low conversion and detection rates.
