Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS

Objectives Early MRI use varies in the management of acute wrist injuries in the UK, with only a minority of National Health Service (NHS) centres being able to offer this to patients. In this study, we aim to explore the perspectives of staff and patients on the use of early MRI in the management o...

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Main Authors: Benjamin John Floyd Dean, Helen Hedley, Tim Stephens, Edward Sellon, Nicholas Riley, Liz Baird, Francine Toye, Sam Gidwani, Stephen Lipscombe, Ramesh Chennagiri, David Lawrie, Eoghan Donnelly, Christopher Little, Paul Jenkins, David Metcalfe, Matt Costa, Amy Grove, Gail Lang, Ashley Scrimshire, Jenna Burford, Daniel Cadoux-Hudson, Mark Brewster, Iain Rankin, Anna Berridge
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/4/e098580.full
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author Benjamin John Floyd Dean
Helen Hedley
Tim Stephens
Edward Sellon
Nicholas Riley
Liz Baird
Francine Toye
Sam Gidwani
Stephen Lipscombe
Ramesh Chennagiri
David Lawrie
Eoghan Donnelly
Christopher Little
Paul Jenkins
David Metcalfe
Matt Costa
Amy Grove
Gail Lang
Ashley Scrimshire
Jenna Burford
Daniel Cadoux-Hudson
Mark Brewster
Iain Rankin
Anna Berridge
author_facet Benjamin John Floyd Dean
Helen Hedley
Tim Stephens
Edward Sellon
Nicholas Riley
Liz Baird
Francine Toye
Sam Gidwani
Stephen Lipscombe
Ramesh Chennagiri
David Lawrie
Eoghan Donnelly
Christopher Little
Paul Jenkins
David Metcalfe
Matt Costa
Amy Grove
Gail Lang
Ashley Scrimshire
Jenna Burford
Daniel Cadoux-Hudson
Mark Brewster
Iain Rankin
Anna Berridge
collection DOAJ
description Objectives Early MRI use varies in the management of acute wrist injuries in the UK, with only a minority of National Health Service (NHS) centres being able to offer this to patients. In this study, we aim to explore the perspectives of staff and patients on the use of early MRI in the management of wrist injuries.Design This is a cross-sectional qualitative study using semistructured, face-to-face and remote interviews. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis.Setting 10 NHS Trusts in the UK.Participants We interviewed a sample consisting of 37 NHS staff members and 21 patients.Results We analysed the data into three overarching themes. The first theme described the negative impact of wrist injuries on both staff and patients. Staff reported an uncomfortable feeling that they had ‘short-changed’ patients with older non-MRI based pathways, and that the consequences of missing a scaphoid fracture could be a ‘horrible thing’ for patients. The second theme described how early MRI was perceived as a ‘win for everyone’. For patients, the win encompassed the relief of a speedy diagnosis which helped them to get better. Staff saw early MRI as a win because it ‘revolutionised care’ and ‘reduced the clinic footprint’. The final theme defined the key ingredients of delivering an early MRI pathway: a simple pathway with clear accountability, timely access to MRI and prompt reporting of results, a safe pathway with safety nets to avoid patients being lost, data and audit of the time to MRI and definitive treatment, bottom-up engagement, clear communication and looking after your team.Conclusions Our findings contribute to a better understanding of stakeholders’ perspectives on wrist injury pathways in the UK NHS.
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spelling doaj-art-2935d23c668a47a08d31cb461ff9a0102025-08-20T03:03:25ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-098580Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS 0Benjamin John Floyd Dean1Helen HedleyTim Stephens2Edward SellonNicholas RileyLiz Baird3Francine Toye4Sam GidwaniStephen LipscombeRamesh ChennagiriDavid LawrieEoghan DonnellyChristopher LittlePaul JenkinsDavid MetcalfeMatt CostaAmy Grove5Gail Lang6Ashley ScrimshireJenna BurfordDaniel Cadoux-HudsonMark BrewsterIain RankinAnna BerridgeGenes & Health, Queen Mary University of London, London, UKDepartment of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford, UKCritical Care and Perioperative Medicine Research Group, Queen Mary University, London, UKNDORMS, University of Oxford, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKWarwick Medical School, University of Warwick, Coventry, UKNDORMS, University of Oxford, Oxford, UKObjectives Early MRI use varies in the management of acute wrist injuries in the UK, with only a minority of National Health Service (NHS) centres being able to offer this to patients. In this study, we aim to explore the perspectives of staff and patients on the use of early MRI in the management of wrist injuries.Design This is a cross-sectional qualitative study using semistructured, face-to-face and remote interviews. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis.Setting 10 NHS Trusts in the UK.Participants We interviewed a sample consisting of 37 NHS staff members and 21 patients.Results We analysed the data into three overarching themes. The first theme described the negative impact of wrist injuries on both staff and patients. Staff reported an uncomfortable feeling that they had ‘short-changed’ patients with older non-MRI based pathways, and that the consequences of missing a scaphoid fracture could be a ‘horrible thing’ for patients. The second theme described how early MRI was perceived as a ‘win for everyone’. For patients, the win encompassed the relief of a speedy diagnosis which helped them to get better. Staff saw early MRI as a win because it ‘revolutionised care’ and ‘reduced the clinic footprint’. The final theme defined the key ingredients of delivering an early MRI pathway: a simple pathway with clear accountability, timely access to MRI and prompt reporting of results, a safe pathway with safety nets to avoid patients being lost, data and audit of the time to MRI and definitive treatment, bottom-up engagement, clear communication and looking after your team.Conclusions Our findings contribute to a better understanding of stakeholders’ perspectives on wrist injury pathways in the UK NHS.https://bmjopen.bmj.com/content/15/4/e098580.full
spellingShingle Benjamin John Floyd Dean
Helen Hedley
Tim Stephens
Edward Sellon
Nicholas Riley
Liz Baird
Francine Toye
Sam Gidwani
Stephen Lipscombe
Ramesh Chennagiri
David Lawrie
Eoghan Donnelly
Christopher Little
Paul Jenkins
David Metcalfe
Matt Costa
Amy Grove
Gail Lang
Ashley Scrimshire
Jenna Burford
Daniel Cadoux-Hudson
Mark Brewster
Iain Rankin
Anna Berridge
Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS
BMJ Open
title Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS
title_full Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS
title_fullStr Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS
title_full_unstemmed Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS
title_short Qualitative study exploring stakeholder perspectives on the use of early MRI in wrist injury pathways in the UK NHS
title_sort qualitative study exploring stakeholder perspectives on the use of early mri in wrist injury pathways in the uk nhs
url https://bmjopen.bmj.com/content/15/4/e098580.full
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