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Why it matters

Patient safety · Good clinical practice · Closing the loop

Protect patients

Unactioned results lead to missed diagnoses, delayed treatment and avoidable harm.

Close the loop

Every result needs a clear owner, action and follow-up plan documented in ieMR.

Endorsement is final

After endorsement, no one else will review the result. Only endorse when the patient is safe.

Core principles: Patient safety first · Decide new vs known · Communicate with patient/GP/inpatient team · Document everything.
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Assessing a result

Five questions before you act
1
Clinically important now?Time-critical Dx, missed injury, malignancy, infection.
2
Correlates with presentation?Does it match symptoms and exam?
3
Already known?Notes, prior imaging, pathology, correspondence.
4
Report recommendation?Surveillance, referral or GP review suggested?
5
Who is responsible?ED, inpatient team, GP or specialty.
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Is it already known?

Check these sources before deciding the finding is new

ieMR

  • ED & progress notes
  • Discharge documentation
  • Pathology & problem list
  • Correspondence

The Viewer / PACS

  • Compare with prior imaging
  • Read prior reports for context

My Health Record

  • Shared health summaries
  • Specialist letters
  • Identify likely usual GP

GP & Patient

  • Call GP to confirm prior workup
  • Ask patient what they know
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Common scenarios

Click a tab to see the approach

First steps

If highly suspicious of cancer

  • Cat 1 Refer Your Patient via QHrefer by treating clinician.
  • Inform patient and GP of arranged follow-up.

Patient contact

  • Call patient — correlate symptoms with imaging.
  • Splint, analgesia, fracture clinic follow-up as indicated.
  • Bring back to ED if splinting required.

Resource

Use the local orthopaedic injury guide for management.

Treatment

  • If antibiotics inappropriate, call patient and review symptoms.
  • Use Therapeutic Guidelines for antimicrobial advice.
  • Prescribe in ieMR · fax + mail to pharmacy, or leave labelled script at triage.

Follow-up & tracing

Common findings

  • CT: AAA, coronary calcification, emphysema, vertebral #, renal/adrenal/liver/pancreatic/splenic/thyroid lesions, lymphadenopathy.
  • US: ovarian cysts, fibroids, endometrial thickening, gallbladder polyps, biliary dilatation, hydronephrosis.

Approach

  • Check ieMR, Viewer, My Health Record for prior knowledge.
  • Follow radiologist's recommendation where given.
  • New + non-urgent → GP in writing.
  • Urgent / serious → contact patient directly.
  • Admitted → hand over to inpatient team.
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Who to contact

Patient · GP · Inpatient team

Patient

  • Callback line: 07 5687 5224
  • Switch: 07 5687 000
  • Try ≥2× day 1, ≥1× another day.
  • Non-English: book via Interpreter Online.
  • No contact → SSU consultant 0756875215, consider GP/NOK, send letter.

GP

  • Identify usual GP via My Health Record.
  • Phone for urgent issues, write for routine.
  • In ieMR: state result, action taken, exact follow-up + timeframe.
  • Forward message from Documentation View → GCUH Letters Direct to GP (pool); Medical Records sends next business day.

Inpatient team

  • Patient admitted under them.
  • Their scan accidentally returned to ED.
  • Result arrived after admission needing action.
Hand over: result + time, significance, new vs known, prior contact, action needed, location in ieMR.
✓

Before endorsing a result

All boxes ticked — patient is safe
  • Report reviewed; clinical relevance understood.
  • Already-known status checked (notes, Viewer, MHR).
  • Responsibility for follow-up decided.
  • Patient contacted, or attempts documented.
  • GP informed if community follow-up needed.
  • Inpatient team informed if responsible.
  • Scripts, repeat tests, referrals or return instructions arranged.
  • Documentation complete.
Important: Once endorsed, no one else will review the result. Only endorse when the loop is fully closed.
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When to click the follow-up button

Only for follow-up that was otherwise missed from care
1
Identify missed follow-upCare plan didn't capture it.
2
ED / inpatient arranges itSet up the follow-up first.
3
Click follow-up + endorseBoth buttons can then be clicked.
4
Notify senior reviewURN & details to Adam Brand.
Send URN and patient details to adam.brand@health.qld.gov.au for senior review and possible incident report.
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Documentation

Every step recorded in ieMR

Unable to contact

Write a standard note: attempts made, risk assessment, and next steps for colleagues over coming days.

Contact made / advice given

Use Adhoc icon → Telehealth Form. Creates an ieMR note and generates a retrospective appointment for coding.

Golden rule: If it isn't documented, it didn't happen. Document conversations, advice, prescriptions and follow-up plans.