Triage turns accepted demand into prioritized work
After intake confirms that a referral is usable, triage decides how urgently it should move, whether it belongs in the requested service, and whether more clinical review is required before booking.
This is where policy, appropriateness guidance, and local operating rules intersect. A system that books before triage may fill capacity with poorly targeted work while urgent patients wait in the wrong queue.
Triage and protocoling state machine
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ACR Appropriateness Criteria overview
Reference for how imaging appropriateness is evaluated against evidence and expert review before exams are selected.
Review the appropriateness frameworkCommunity Referred Radiology primary-care guidance
Health New Zealand primary-care guidance describing the national CRR referral criteria and priority model.
Read the CRR primary-care guidanceProtocoling creates the executable plan for the service
Protocoling is where the receiving clinical team decides what exactly should happen once the patient arrives. In imaging, that may include modality changes, contrast decisions, sequence selection, lab prerequisites, or extra safety screening.
Typical protocoling decisions
| Decision area | Example question | Operational impact |
|---|---|---|
| Appropriate modality | Is MRI, CT, ultrasound, or specialist review the right next step? | May change destination, slot length, and equipment needs. |
| Contrast and safety | Does the patient need contrast and are labs or contraindication checks required? | Adds prerequisites and may require nurse, consent, or lab review. |
| Preparation | Does the patient need fasting, medication pauses, or implant screening? | Changes patient instructions and readiness criteria. |
| Priority and protocol variant | Is this routine, urgent, or same-day work? | Determines queue ordering and escalation path. |
Do not collapse protocoling into a hidden comment field
If execution-critical decisions only exist as narrative notes, schedulers, technologists, and downstream systems cannot reliably enforce them.
ACR Manual on Contrast Media
Operational reference for patient selection, preparation, and risk management around contrast administration.
Read the contrast manualACR MR Safety guidance hub
Current ACR guidance hub for MR safety practice, including the 2024 manual and related safety references.
Review MR safety guidancePriority labels only matter when they change queue and slot behavior
A triage outcome is operationally weak if it never changes how the receiving organization allocates capacity. Routine, urgent, and same-day referrals should not all disappear into the same generic backlog with identical timers and slot rules.
Protocol choices also reshape scheduling reality. Contrast checks, infection isolation, sedation, special equipment, or specialist review can change location, slot duration, staffing, and patient instructions before the booking team even starts calling patients.
From triage priority to real capacity behavior
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A note field does not reserve urgent capacity
If urgency only appears in narrative text, schedulers and automated booking rules cannot reliably protect the right slots or trigger the right preparation steps.
Community Referred Radiology primary-care guidance
Health New Zealand guidance that shows how referral criteria and priority rules are expected to affect community-radiology access decisions.
Review priority and access criteriaACR Manual on Contrast Media
Operational guidance illustrating how protocol and safety decisions change prerequisites, staffing, and readiness before an exam can be booked cleanly.
Review protocol-dependent prerequisitesKnowledge Check
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