Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction

The Effects of Fatigue From Overnight Shifts on Radiology Search Patterns and Diagnostic Performance

“…We corroborate and quantify these alterations with eye-tracking technology and provide insight into the specific mechanistic changes that occur when a fatigued radiologist views individual studies. With the increase in afterhours radiology volumes and the commensurate increase overnight radiology staffing, this issue becomes more important for schedule optimization and error minimization (1–3). Perceptual errors (the failure to detect an abnormality) account for the majority of errors in radiology and can result from faulty visual search patterns (25, 26).…”

“…Increasing evening and overnight diagnostic radiology volumes coupled with the growing demand for contemporaneous radiology interpretations has fueled an increase in atypical diagnostic radiology schedules (1–3). In addition, a substantial portion of afterhours work is emergent requiring shorter radiology report turnaround times to decrease patient length of stay and improve overall emergency department (ED) flow (4).…”

Addressing Burnout in Radiologists

“…Other factors contributing to a sense of work overload include long work days with increased after hours responsibilities, greater expectations for report turnaround times, conflicting demands on time (clinical, academic, administrative), and inadequate staffing (25,28). Studies also report that radiologists working a higher number of night shifts may be at a higher risk of burnout (31).…”

Workload for radiologists during on-call hours: dramatic increase in the past 15 years

“…Higher volumes and complexity of cases put increasing pressure on radiologists to read more studies in a shorter period [1]. This results in longer working hours and reading fatigue, all of which contribute to diagnostic error [1][2][3]. Diagnostic errors are a major source of patient harm and result in death more often than any other medical error [1].…”

“…Emergency radiology studies during on-call hours may be particularly prone to diagnostic error due to relative staff shortage and absence of subspecialty trained attending radiologists. In addition, long shifts and high workloads are considered stressful, have negative health effects and can lead to burnout among radiologists [3,4] and also among radiology technicians [5,6]. Previous studies published in the early 2000s have demonstrated a 22% increase of radiological examinations during on-call hours over a four-year period in the USA [7] and an 85% increase over an eightyear period in the UK [8].…”