A practical review-and-sign workflow for radiology reports

Why does a consistent review routine matter?

A consistent review routine matters because it turns checking into a habit rather than a judgement call each time. When you check the same things in the same order, you are less likely to miss one when you are busy or tired.

Without a routine, review tends to become a quick read for sense. Fluent text can hide small but important errors, such as a wrong side or a dropped "no", precisely because it reads well.

A routine does not need to be long. A handful of focused checks, done every time, is more useful than an exhaustive list that is followed only occasionally.

• Reduces reliance on memory when busy.
• Catches errors hidden by fluent text.
• Makes review quicker over time.

What is the first thing to check in a draft?

The first thing to check is that the draft belongs to the right study and patient reference and that the indication matches the clinical question. Everything else depends on this.

Confirm the patient reference, the study type and the date. Then read the indication and ask whether it reflects why the study was requested. If the question is wrong, the conclusion may answer the wrong thing.

Using patient reference codes rather than names, where your practice allows, keeps drafts tidy and reduces the amount of identifying detail in working documents.

• Correct patient reference.
• Correct study type and date.
• Indication matches the clinical question.

How should you check the findings section?

Check the findings section by reading it against your memory of the study and, where available, your original transcript, with particular attention to laterality, measurements and negations. These are the details most often changed by misrecognition or editing.

Look for each left, right and bilateral and confirm it is correct. Check every number and unit. Look for words such as "no", "not" and "without" and make sure none have been dropped or added. Then read the section through for order and sense.

In Medicate, the structured draft sits beside the raw transcript, and laterality words and numbers that do not appear in the transcript are highlighted. Use these as prompts, then read the whole section yourself.

• Every laterality word is correct.
• Every measurement and unit matches your dictation.
• Negations are present where intended.
• Findings follow a sensible order.

How should you check the conclusion?

Check the conclusion by confirming that it answers the clinical question, that its most important point comes first and that everything in it is supported by the findings. It should make sense to a reader who reads nothing else.

Make sure the conclusion has not introduced anything that is not described above. If a recommendation is included, check that it is clearly worded and separated from the description of findings.

Read the conclusion once more as the referrer will see it. If it would prompt a question you could answer in the report, add the answer now.

• Answers the clinical question.
• Most important point first.
• Supported by the findings.
• Clear on its own.

How do you make corrections without introducing new errors?

Make corrections with the smallest change that fixes the problem, and reread the sentence afterwards. Large rewrites at the review stage are where new errors creep in.

For single words, a replace or delete command is precise. In Medicate, you can say or type "replace moderate with mild in findings" and only that phrase in that section changes. For a sentence that is mostly wrong, re-dictate or retype it in full.

After any correction, check that grammar still works and that the meaning is what you intended. If you changed a word that appears elsewhere, check the other places too.

• Prefer small, targeted changes.
• Re-dictate whole sentences that are badly wrong.
• Reread every corrected sentence.
• Check repeated terms elsewhere in the report.

What should you confirm just before signing?

Just before signing, confirm the referrer, your signature and the output format, and take one final read of the whole report from top to bottom. This last pass is short but catches problems that section-by-section checks can miss.

Make sure the right referring physician is selected, especially where several share a surname. Check that your signature and letterhead are the current versions. Decide which file format the referrer needs.

In Medicate, the Sign step brings these together: you pick the referrer from your directory, add your saved signature and then download the report as a PDF or Word file. Signing marks the report as signed in your dashboard.

• Correct referring physician selected.
• Current signature and letterhead.
• Agreed file format.
• One final top-to-bottom read.

How do you keep the routine going on busy days?

Keep the routine going on busy days by making it short enough to follow every time and by building it into the tools you already use. A checklist that only works on quiet days does not help when it is needed most.

Write the checks down and keep them visible beside your screen until they become automatic. Review each report straight after dictating rather than letting drafts accumulate, because a long queue of drafts encourages rushed reading. If you are interrupted mid-review, start the checklist again from the top rather than guessing where you stopped.

Take short breaks between long sessions. Attention to detail fades with fatigue, and the checks in this routine depend on careful reading. Colleagues can help too: agreeing a shared routine across a team makes it easier to hand over drafts and to discuss any errors that are found.

• Keep the checklist short and visible.
• Review straight after dictating.
• Restart the checklist after an interruption.
• Take breaks during long reporting sessions.
• Share the same routine across the team.

What happens after the report is signed?

After signing, the report should be shared through your practice's agreed channel and kept as a record. Any later change should follow your department's process for amending signed reports rather than quietly editing the original.

Medicate does not send emails. You download the signed file and share it yourself, which keeps you in control of where it goes. The signed report remains in your dashboard, separate from drafts.

Over time, notice which checks catch the most problems in your own reports and adjust your dictation habits accordingly. Review is also a source of feedback.

Medicate structures dictated text; the physician reviews and signs every report. It is not a diagnostic tool.

Frequently asked questions