Reject analysis: A comparison of radiographer and radiologist perceptions of image quality

•Significant differences are found to exist in perceptions of image quality.•Differences in perceptions of image quality directly influence reject rates.•Radiographers judge images on technical criteria.•Radiologists judge images on diagnostic criteria.•Results suggest better communication could reduce reject rates.

This study explores the potential differences in perceptions of image quality between radiographers and radiologists in a large UK hospital and the subsequent impact this has on image rejection. Image rejection, while sometimes necessary, often leads to an increased radiation dose to the patient due to the need to repeat. Moreover, this translates into increased waiting times, departmental costs, and lower patient satisfaction. Adopting a mixed methods approach, this paper first seeks to quantify the differences in radiographer and radiologist perceptions and second establish the underlying causes of such differences through a quantitative and qualitative investigation respectively. Using a standardized psychometric scale of a GP lateral knee, the study reveals significant differences in the perceptions of quality and rejection rates between radiographers and radiologists driven by a conflict in the evaluation criteria used. The study has significant implications for improving departmental performance and proposes a potential solution for reducing reject rates and image repeats.