Happy 5th Birthday!

This month’s blog is a celebratory look back at the history of MedRadJClub and has been compiled by MRJC’s Kim Meeking.

---

If you were anywhere near the internet on 16^th March, 2015 at 8pm GMT, you would have known, quite possibly felt, that something very special was happening in the world of radiography and medical radiation science. It was of course, the inaugural Med-Rad-Journal-Club tweetchat! Here we are, 5 years and nearly 60 chats later, to say a very special Happy Birthday the one and only online journal club for radiation professionals from around the world! >>Insert firework sounds here<<

So how did it all start? How has it evolved? And what has the future got in store for #MedRadJClub? I took these questions to four of the co-founders to find out the MedRad story. You can read their answers below, but first of all, let me introduce you…

Dr Nick Woznitza @xray_nick – Nick is a reporting radiographer extraordinaire. His PhD research was on accuracy and impact of radiographer reporting. He is a clinical academic consultant radiographer at Homerton University Hospital & Canterbury Christ Church University, Kent, UK

Julia Watson @julia_watso – Julia is an MRI Radiographer and is mid-way through her PhD researching the transition from acute to chronic pain using magnetic resonance spectroscopy at Queensland University of Technology and Translational Research Institute, Brisbane, Queensland, Australia

Adam Westerink @adamwesterink – Adam is the Acting Radiographer Assistant Director at the Department of Medical Imaging in Royal Brisbane Women’s Hospital. He is also the Queensland representative on the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) Board of Directors.

Dr Amanda Bolderston @AmandaBoldersto – Amanda is a radiation therapist and has recently completed a doctorate of education studying the the experiences of LGBTQ healthcare professionals. Amanda is a faculty educator in the undergraduate radiation therapy program at the University of Alberta in Canada.

---

So… how did it all begin?

Julia: Haha! I was on Twitter and came across an online urology journal club. I thought it was a great idea and messaged a couple of people and said, “hey, should we start one for rads?” Nick took to the idea like strawberries to champagne, messaged a few people including Amanda and the rest is history…

What’s the story behind the name?

Adam: We wanted something that would stand the test of time – I think we nailed it!
Amanda: Julia came up with it – I think – the term medical radiation sciences is used a lot in Australia – it’s inclusive and sounds impressive!
Nick: Medical Radiation Journal Club, or MedRadJclub – what else could it have been!

What were the original aims?

Adam: 1. Build networks 2. Grow the concept 3. Be truly international 4. Have fun???
Julia: To increase CPD access for those that had difficulty accessing other events and to enable networking and collaboration.
Amanda: I think our original aims were close to a normal journal club, critically examine a paper, but we wanted somewhere that was more inclusive than a face to face venue. I think we’ve been a lot broader than the original aims – the focus is on research and evidence based practice but we have chats without papers, meet ups, fun chats at Christmas and we’ve helped a lot of people interested in research as well as created a great network.
Nick: To increase research awareness and evidence based practice among radiographers. It’s become a fantastic global community of practice, sharing examples from practice and enablers to improve care.

How do you think #MedRadJClub has changed over the last 5 years?

Amanda: We added blogs along the way and expanded the scope beyond just looking at one paper. We’ve had to be broader as we’re dealing with a few disciplines but I think it’s added to the interest. Our top chats are wider topics like patient experience and LGBTQ healthcare.
Adam: I think we have progressively taken more risks in the topics that we chose to discuss. The conversations have become more robust as we have matured.
Nick: The biggest change I think has been the move from 140 to 240 characters on Twitter!

What chat sticks in your mind and why?

Amanda: The first one! I was on holiday and was in a beachside bar in La Jolla in California. I was also having lunch with a friend whom I ignored for an hour. Luckily she’s a good friend!
Nick: The epic 15-hour chat on compassionate care (May 2016) … 8 hours moderating across time zones, a fab bunch of enthusiastic radiographers and contributing to data collection for a PhD!
Adam: I loved the time management chat with Frank Gaillard (Sept 2016). I’m fascinated by how people approach tasks and life and how they integrate work and life.
Julia: Probably the first chat I moderated. I was so nervous and spent hours preparing. Only to realise that these chats really take on a life of their own and there was nothing to worry about!

There have been nearly 60 unique tweetchats, publications, presentations, meet ups and more… What #MedRadJClub moment are you most proud of?

Julia: That we have made it to 5 years! A number of other online journal clubs that began before or after us have fallen by the wayside and we have just grown stronger.
Adam: The publications have been fantastic as well as the conference presentations. I am also very proud of how we have been able to engage different audiences along the way.
Amanda: I loved going to ASMIRT in Brisbane a few years ago because I got to meet Adam and Julia – and Julia and I did a social media workshop to plug MRJC.
Nick: Proudest achievement? Shout outs to MedRadJclub by Suzanne Rastrick during her keynote presentation at the Chief Allied Health Professions Officer conference in 2016 – Look!

Many journal clubs fizzle out because interest dwindles, or a lack of time for facilitation etc, but it’s been 5 years now… what’s the secret?

Nick: A healthy doses of optimism, sarcasm and insanity in equal proportions! Having an enthusiastic core group of dedicated radiographers, reaching out to their global network and the unwavering support of JMRS, JMIRS and Radiography journals and EICs makes it all possible.
Adam: Organisation! (Or lack of? Please forgive the chat where I was due to moderate and I slept through my alarm!)
Amanda: GIFs probably. I think we have fun, that’s important. We also have a group of fabulous MedRadJournalClub’ers who participate a lot and that makes it more of a community feel.
Julia: This is mostly due to Amanda’s work and commitment to the club. It is also giving the community a range of topics to keep them interested.

What will make another 5 years possible?

Nick: Engaging with our marvelous participants to select themes and topics relevant to radiography practice
Amanda: If people are still interested? We’re doing this to help introduce people to different papers, perspectives and research ideas – we’ll keep doing it as long as there is an interest.
Julia: Continue to involve people behind the scenes (like you Kim, you’re brilliant) who bring in fresh exciting ideas. Continue to listen to what the MedRadJClub community want in the way of articles and topics and evolve as they do. Continue to try to get students involved as more likely to continue participation as their career progresses.
Adam: Building the MedRadJClub family and continuing to have fun and learn.

If you could choose any topic to discuss in a future (imaginary) journal club, what would it be?

Julia: More on AI as we are going to become more and more involved as time progresses.
Nick: Cake vs. donuts – what do you take to work to celebrate your birthday?
Adam: I would love to run a session that focuses on our profession in 20 years. Where will healthcare in 2040?
Amanda: Probably the novels of Stephen King but it’s not very radiographical.

Finally, what would you like to say to the participants that show up every month? (In 240 characters or less 😉)

Nick: Thank you #MedRadJclub for such an amazing time. I have engaged with, collaborated with and learnt so much from you all!
Amanda: Thanks for making the last five years a success! You rock!
Adam: Let’s continue to learn and have fun. I would love to meet each of the 400 individuals who have participated in our chats!
Julia: You are amazing and we would not be here if it wasn’t for you. Thank you!!!

Never mind the width, feel the quality

Christine Woodgate, MSc, PgD, PgC, DCR(R) is QI Partner for RCR/SCoR. Chris has worked within the NHS since 1980 as Radiographer, Advanced Practitioner, Radiology Manager and a Divisional Director, taking retirement in 2016 to work part-time for the colleges.  She can be contacted at QSI@rcr.ac.uk

Never mind the quality feel the width was a typically 1960’s politically incorrect British TV sitcom about the ‘rag trade’ with two tailors, one Catholic and one Jewish. However in popular culture the title of this sitcom has become synonymous with quantity being more important than quality (1).      

In my time as a senior manager within the NHS within the relentless call of ‘do more with less’ this phrase often came to mind and that if we were not careful it was a slippery slope down to the lowest common denominator. 

Change is good when done for the right reasons i.e. from an evidence base, how many of us would still want to be working with the equipment and understanding of patient care/medicine we had in the eighties?  Change to allow better patient flows, quicker treatment paths, shorter length of stay all benefit patients; but if these changes come at the cost of the quality of care we can offer is it right?

Quality Standard for Imaging (QSI) is a program developed and owned by the College of Radiographers and the Royal College of Radiologists to support diagnostic imaging services to make continuous improvements. QSI all about quality and quality improvement; it allows Imaging Services to develop an evidence base for what they do, has an audit regime which meets the NHS desire to transform services and can provide performance data on an ongoing basis.  However when as professionals we think about reject analysis, repeat examination analysis (easier said than done in the digital age for those old enough to remember film) is this audit or monitoring and what is the difference?

I found these definitions, which were simple enough for me to understand (albeit they are from the financial sector):- 

1. Audit – is a formal, systematic and disciplined approach designed to evaluate and improve the effectiveness of processes and related controls, governed by professional standards e.g. clinical audit.
2. Monitoring – is an on-going process to ensure processes are working as intended and can be an effective detective device within a process. It often uses audit techniques and is typically an operational activity, e.g. reject analysis. 

The words which really captured my attention were ‘detective device’ this feeds my inner ‘Miss Marple/Hercule Poirot’.  How as radiographers do we know we are safe, effective, patient centred, and producing diagnostic images? In the Clinical domain of the QSI (CL2C3) evidence is required to demonstrate that as professionals diagnostic radiographers are producing optimal diagnostic images. 

In your efforts to meet performance targets both operational (are you getting the numbers through) and financial (efficient working practice) are you trapped in a ‘never mind the quality feel the width’ mentality, is quantity outweighing quality? Are you monitoring your quality, your patient dose?  How about your feedback loop, who tells you when the images are not good enough, who decides the images are not good enough, who tells you there are too many repeats, who advises you how quality can be improved, who tells you if the patient dose is safe? Then in turn who is monitoring your feedback loop?  

You can’t change or improve if you don’t know change or improvement is necessary, why not start with an audit to find your baseline you might be surprised by the results.  Once you have a baseline perhaps decide quality measures you want to put in place, then you can monitor against these at regular intervals. You might want to tweak them depending on the results of the monitoring process.  Then complete another formal audit and compare/contrast the results with your original audit.  

Feedback is key to all of these processes;

• Does everyone know/understand what you are trying to achieve and take ownership
• Is everyone following your quality measures/standards
• Do you get feedback from those who report your images
• Are there regular updates on monitoring results 
• Is training offered to meet the quality expectations

I am sure you could add to this list and demonstrate how feedback has changed the way quality is monitored in your service. 

Why not investigate this further?  Perhaps it is time for you to be able to garner the evidence to say ‘never mind the width feel the quality’ 

1 Editorial Australian Journal of Forensic Sciences 2015. Vol 47, No. 1, 1-2, Taylor & Francis Group.