Overview
Initiative type
Service Improvement
Status
Deliver
Published
June 2026
Summary
This comparative clinical audit evaluates the efficacy of an online automation tool in improving annual MRI safety screening compliance among imaging staff.
Dates: Ongoing
Implementation sites: Royal Brisbane and Women's Hospital
Aim
To assess whether automating expiry notifications and record-updating processes improves staff compliance with mandatory annual MRI safety screening within a public hospital setting.
Outcomes
Total staff compliance rose significantly from a pre-trial rate of 28.47% in October 2024 to 96.07% by February 2026. The implementation achieved a total compliance increase of 66.29% (p < 0.05). The project successfully integrated Microsoft Outlook, Power Automate, Lists, Forms, and Power Apps to create a seamless, end-to-end compliance management system.
Background
Magnetic Resonance Imaging (MRI) environments pose unique safety challenges due to powerful electromagnetic fields and rapidly changing magnetic gradients. To mitigate these risks, the International Society for Magnetic Resonance in Medicine (ISMRM)1 and the Royal Australian and New Zealand College of Radiologists (RANZCR)2 both recommend all staff involved in MRI operations to complete annual MRI safety screening.
Initial screening of staff is performed during their orientation and induction where their safety records and the date completed are recorded. This involved completing a questionnaire declaring all medically implanted devices where an MRI team member would assess such devices (e.g. pacemaker) for MRI safety. Updating theses records annually is driven by MRI staff manually searching through the list of staff and selectively emailing individuals whose MRI safety records have not been updated within the last 12 months.
This process relied on the notified staff to present to MRI, during work hours, to update their records with MRI staff in person. Because of these inefficiencies, annual staff screening at a Queensland public hospital has proven to be infrequent and inconsistent (28-36% compliance). To address this, a novel automation tool was developed and implemented to streamline MRI safety compliance. This tool automated staff notifications of annual expiry, provided an online update form and updated staff records.
Methods
An online list was created through Microsoft Lists which stored staff compliance, expiry dates and email addresses. This list was accessible and editable through a created app within Microsoft PowerApps. Several automations created through Microsoft Power Automate analysed the List, identified expired staff members and sent an automated email (through Microsoft Outlook) to them notifying them of their expiry.
This email also provided a link to a Microsoft Forms page where staff could update their MRI safety online. If they provided no changes to their safety status, another automation tool would automatically update their records on Lists with an extra 12 months of compliance. If they flagged changes (e.g. changes to recent surgical history, new medical device, etc.), the tool would instead notify MRI staff to follow up with the individual to manually confirm compliance. This second action acted as a safety net.
A comparative monthly audit of all clinical medical imaging staff from January 2024 – February 2026 was performed. The automation tool was implemented from November 2024 with the preceding 10 months used as a pre-trial control. During this period, staff who were compliant (<12 months since last completion) in MRI safety were expressed as a percentage of total medical imaging staff. Results indicate total staff compliance rose from 28.47% (October 2024) pre-trial to 96.07% (February 2026) (p=<0.05) post-trial.
Discussion
The implementation of the automation tool proved highly effective in increasing and maintaining staff MRI safety compliance. Total staff compliance rose from a pre-trial rate of 28.47% to 96.07% post-trial (p < 0.05), representing a total increase of 66.29%. This significant improvement highlights the efficacy of a digital approach in sustaining high compliance rates, particularly within the resource-constrained environments typical of public hospitals. The project’s success was largely dependent on leveraging the existing Microsoft Office suite infrastructure already within Queensland Health - specifically Outlook, Power Automate, Lists, Forms and Power Apps. Utilising these highly integrated tools allowed for a solution without the need for additional software procurement or extensive external IT support. This environment enabled the transition from an infrequent and inconsistent manual process to a streamlined, automated workflow. A key lesson from this study is that manual administrative processes are slow, time-consuming, inefficient often fail to meet national safety guidelines in high-pressure clinical settings.
By automating notifications and providing an accessible online update form, the project reduced the administrative burden on individual staff members, leading to the rapid uptake of compliance. A limitation of this approach is its reliance on staff engaging
with digital notifications and emails; while highly effective, it requires the underlying staff database to remain engaged and responsive to their Queensland Health emails. A staff member who doesn’t use or regularly monitor their emails may likely not remain compliant. This automation framework has substantial potential for scalability across other medical imaging departments within Queensland Health. These tools can be copied and transferred at will to other sites for implementation given this suite is available to all Queensland Health staff.
Furthermore, the logic used to track MRI safety compliance can be adapted for any other mandatory certification or recurring training requirement, such as:
- Advanced Life Support (ALS) certifications.
- Radiation Safety licenses.
- Hand hygiene and fire safety mandatory training modules.
The next phase of this project involves expanding the tool to include other medical imaging modalities beyond MRI. This includes (but isn’t limited to) aseptic technique skills refreshers within CT, lead gown auditing within Angio and basic life support training.
References
1. International Society of Magnetic Resonance in Medicine. Safety Guidelines for Magnetic Resonance Imaging Equipment in Clinical Use. In: Agency MaHPR, editor. 2014. p. 85.
2. Royal Australian and New Zealand College of Radiologists. MRI Safety Guidelines. In: Faculty of Clinical Radiology, editor. Sydney2021. p. 36.
Key contact
Cameron Brown
Advanced Skills Radiographer
Royal Brisbane and Women's Hospital