Preparing Radiography Departments for the roll out of the National Stroke Thrombectomy Service – learning to “ask smart people dumb questions” by Jenny Hamilton, Specialist Radiographer, NHS Lothian, @jimpson_5 #AHPCFS2022 @NESnmahp

I applied to be part of the AHP Fellowship Scheme. I was looking to raise awareness and help prepare Radiography Departments for the roll out of the National Stroke Thrombectomy Service. Like so many other things, the pandemic came along and flipped my plans. The start of my project was delayed and to this day I have only met my fellow Fellows virtually!

Let’s start with a little context, what is Thrombectomy? Essentially, thrombectomy is a procedure where the blockage causing a stroke is manually removed. It’s minimally invasive, usually performed using a small puncture hole in the groin, and can improve symptoms immediately as blood flow to the brain is re-established there and then. The alternative treatment, the ‘clot-busting’ Thrombolysis drug takes time to dissolve the clot and cannot be given to all patients.

The management of stroke is time critical with the slogan ‘Time is Brain’ often being used to describe the increase in morbidity and mortality which patients encounter if there is a delay to treatment. I had overheard many conversations where my medical colleagues were discussing pathways and protocols for the new Thrombectomy service, and was hyper aware of the key role that CT departments would play. Extra imaging to what is currently the norm would be required and CT radiographers are already extremely busy!

In 2015, the Society and College of Radiographers outlined a requirement to develop a radiography workforce that is engaged with research. The aim of this was to allow radiographers to influence changes in practice based on up to date literature, thus ensuring patients receive a high standard of care. Reading this is partially why I applied for my Fellowship funding. I wanted to make sure that conversations were happening on the ground as well as at the higher levels, and that Radiographers felt supported through this change. This is where I wanted my project to fit in but I had no idea how to make it work.

I listen to a podcast nearly every week where the tagline is “ask smart people dumb questions” and so that is what I did. I got in touch with my local QI team, I spoke to my Radiologist and Radiographer colleagues, and I lent on the other AHP Fellows who came up with the most fantastic perspectives and solutions to problems I faced.

I designed a project which worked in two ways. Firstly, I aimed to standardise the quality of scans so it didn’t matter where a patient presented, they got the necessary imaging to plan a thrombectomy. Secondly, I wanted to empower radiographers through education, so I asked them directly what they wanted and needed to know about. I have to thank everyone who completed questionnaires and tolerated MS Teams conversations with me about scan pitch and contrast medium in the middle of a pandemic.

Radiographers see such a large volume of patients that we have a unique outlook and position on patient care. Our working pattern means we generate a lot of data which other professions would take months to collect and evaluate. This project was my first real venture into QI, but I’m almost certain it won’t be my last. There were points where I felt like I was stepping on toes and points where imposter syndrome took over, but now that I am just about at the end of my Fellowship, these have been overshadowed by the points where I felt like I had made an impact and the little glints of recognition I got for my work along the way.

My project is nearing it’s end and now I am getting to future proof it. My final tasks are to build and release a QI pack, so that departments further afield can also join in on the standardisation of scan quality, and host a virtual study day where Radiographers can learn about the topics they raised.

To follow my progress as my project winds up follow me on twitter @jimpson_5.

Jenny Hamilton

AHP Fellow

Specialist Radiographer NHS Lothian


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s