Emergency Radiology: An Underappreciated Source of Liability Risk

Robinson, Jeffrey D.; Hippe, Daniel S.; DeConde, Robert; Zečević, Mladen; Mehta, Neerav R.

doi:10.1016/j.jacr.2019.08.003

Cited by 11 publications

(11 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 The burden of imaging volumes has increased exponentially over the past few decades. [7][8][9] Thus, rendering not only the emergency radiologists but also radiologists, in general, overburdened. 10 Nevertheless, emergency radiology creates more value by providing finalized imaging reports to the ED physician for every patient encounter.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Role of Artificial Intelligence in an Emergency and Trauma Radiology Department

et al. 2020

View full text Add to dashboard Cite

Emergency and trauma radiologists, emergency department’s physicians and nurses, researchers, departmental leaders, and health policymakers have attempted to discover efficient approaches to enhance the provision of quality patient care. There are increasing expectations for radiology practices to deliver a dedicated emergency radiology service providing 24/7/365 on-site attending radiologist coverage. Emergency radiologists (ERs) are pressed to meet the demand of increased imaging volume, provide accurate reports, maintain a lower proportion of discrepancy rate, and with a rapid report turnaround time of finalized reports. Thus, rendering the radiologists overburdened. The demand for an increased efficiency in providing quality care to acute patients has led to the emergence of artificial intelligence (AI) in the field. AI can be used to assist emergency and trauma radiologists deal with the ever-increasing imaging volume and workload, as AI methods have typically demonstrated a variety of applications in medical image analysis and interpretation, albeit most programs are in a training or validation phase. This article aims to offer an evidence-based discourse about the evolving role of artificial intelligence in assisting the imaging pathway in an emergency and trauma radiology department. We hope to generate a multidisciplinary discourse that addresses the technical processes, the challenges in the labour-intensive process of training, validation and testing of an algorithm, the need for emphasis on ethics, and how an emergency radiologist’s role is pivotal in the execution of AI-guided systems within the context of an emergency and trauma radiology department. This exploratory narrative serves the present-day health leadership’s information needs by proposing an AI supported and radiologist centered framework depicting the work flow within a department. It is suspected that the use of such a framework, if efficacious, could provide considerable benefits for patient safety and quality of care provided. Additionally, alleviating radiologist burnout and decreasing healthcare costs over time.

show abstract

Section: Introductionmentioning

confidence: 99%

Exploring the Role of Artificial Intelligence in an Emergency and Trauma Radiology Department

et al. 2020

View full text Add to dashboard Cite

show abstract

“…This raises the possibility that ED examinations are at higher risk of being the subject of a malpractice claim than inpatient and outpatient examinations. 33 Considering the wide scope of patients that are seen in EDs of hospitals, the literature suggests that radiologists in training tend to overreport abnormalities with an 18% false-positive rate when compared with the subsequent attending opinion. 34 This false-positive rate is reduced in the setting of emergency and trauma radiology, in the presence of the attending radiologist.…”

Section: Discussionmentioning

confidence: 99%

Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time in an Emergency and Trauma Radiology Department

et al. 2020

View full text Add to dashboard Cite

Objective: To study the impact of 24/7/365 attending radiologist coverage on the turnaround time (TAT) of trauma and nontrauma cases in an emergency and trauma radiology department. Patients and Methods: This was a retrospective chart review in which TAT of patients coming to the emergency department between 2 periods: (1) December 1, 2012, to September 30, 2013, and (2) January 1, 2017, to January 30, 2018, and whose reports were read by an attending emergency and trauma radiologist was noted. Results: The 24/7/365 radiology coverage was associated with a significant reduction in TAT of computed tomography reports, and the time reduction was comparable between trauma and nontrauma cases. In adjusted models, the extension of radiology coverage was associated with an average of 7.83 hours reduction in overall TAT (95% confidence interval [CI]: 7.44-8.22) for reports related to trauma, in which 2.73 hours were due to reduction in completion to transcription time (TC; 95% CI: 2.53-2.93), and 5.10 hours were due to reduction in transcription to finalization time (TF; 95% CI: 4.75-5.44). For reports related to nontrauma cases, 24/7/365 coverage was associated with an average of 6.07 hours reduction in overall TAT (95% CI: 3.54-8.59), 2.91 hours reduction in TC (95% CI: 1.55-4.26), and 3.16 hours reduction in TF (95% CI: 0.90-5.42). Conclusion: Our pilot study demonstrates that the implementation of on-site 24/7/365 attending emergency radiology coverage at a tertiary care center was associated with a reduced TAT for trauma and nontrauma patients imaging studies. Although the magnitude and precision of estimates were slightly higher for trauma cases as compared to nontrauma cases. Trauma examinations stand to benefit the most from 24/7/365 attending level radiology coverage.

show abstract

“…Indeed, such interruptions have been shown to cause greater error rates for radiology residents [20]. Moreover, high acuity ED cases have a greater potential for medicolegal hazards compared to inpatient and outpatient cases [21].…”

Section: What Are the Stressors In (Overnight) Ed Radiology Practice?mentioning

confidence: 99%

Update on establishing and managing an overnight emergency radiology division

Scheinfeld

Dym

2021

Emerg Radiol

View full text Add to dashboard Cite

Emergency department (ED) radiology divisions that serve to provide overnight attending coverage have become an increasingly common feature of radiology departments. The purpose of this article is to review the common ED radiology coverage models, describe desirable traits of emergency radiologists, and discuss workflow in the ED radiology setting. ED radiologists may be trained as ED radiologists or may develop the necessary skills and adopt the subspecialty. Choosing radiologists with the correct traits such as being a “night owl” and remaining calm under pressure and implementing an acceptable work schedule such as shift length of 9–10 h and a “one week on, two weeks off” schedule contribute to sustainability of the position. Strategies to address the unique stressors and workflow challenges of overnight emergency radiology coverage are also presented. Workflow facilitators including trainees, PAs, radiology assistants, and clerks all have roles to play in managing high case volumes and in making sure that the service is well staffed. Usage of artificial intelligence software is the latest technique to streamline workflow by identifying cases which should be prioritized on a busy worklist. Implementing such strategies will maintain quality of care for patients regardless of time of day as well as sustainability and quality of life for overnight emergency radiologists.

show abstract

Emergency Radiology: An Underappreciated Source of Liability Risk

Cited by 11 publications

References 7 publications

Exploring the Role of Artificial Intelligence in an Emergency and Trauma Radiology Department

Exploring the Role of Artificial Intelligence in an Emergency and Trauma Radiology Department

Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time in an Emergency and Trauma Radiology Department

Update on establishing and managing an overnight emergency radiology division

Contact Info

Product

Resources

About