Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time of Trauma-Related Imaging Studies Being Finalized Within 48 Hours in an Emergency Radiology Department, Offering a Perspective from a Tertiary Care Hospital

Jalal, Sabeena; Ante, Zharmaine; Ouellette, Hugue A.; Peters, Stephen; Munk, Peter L.; Nicolaou, Savvas

doi:10.1177/0846537120902046

Cited by 2 publications

(4 citation statements)

References 21 publications

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“…51 The use of cross-institutional standardized 24/7/365 care pathways might be one of the potential solutions to eliminating disparities. 52 Our results suggest that despite the exist-…”

Section: Ta B L Ementioning

confidence: 67%

“…51 The use of cross-institutional standardized 24/7/365 care pathways might be one of the potential solutions to eliminating disparities. 52 Our results suggest that despite the existing evidence-based utilization guidelines, further work is needed to improve standardization and decrease currently existing disparities in imaging use for headache in the ED. Implementation of electronic clinical decision support systems 25 can serve as an additional tool assisting practicing physicians with navigating the complexities of imaging utilization in headache in the realities of busy EDs and multiple confounding factors.…”

Section: Discussionmentioning

confidence: 82%

“…Short staffing might be a potential factor contributing to lower imaging utilization on weekends 51 . The use of cross‐institutional standardized 24/7/365 care pathways might be one of the potential solutions to eliminating disparities 52 . Our results suggest that despite the existing evidence‐based utilization guidelines, further work is needed to improve standardization and decrease currently existing disparities in imaging use for headache in the ED.…”

Section: Discussionmentioning

confidence: 91%

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Increasing and disparate use of neuroimaging for adults and children with non‐traumatic headaches in the US emergency departments: Opportunities for improvement

et al. 2020

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Background: Optimization of neuroimaging practices for headache is considered a national priority; however, nationwide patterns and predictors of neuroimaging use for headache in the US emergency departments (EDs) are unknown. Objective: To analyze temporal neuroimaging utilization trends for adults and children with non-traumatic headache in the US EDs and identify factors predictive of neuroimaging use in this patient population. Methods: Retrospective cross-sectional study using the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database for administrative encounter-level data analysis of a nationwide group of adult and pediatric patients with primary diagnosis of headache (ICD-9CM codes 784.0x, 339.xx, 346. xx) visited the US EDs between January 1, 2006 and December 31, 2014. Temporal trends and independent predictors of neuroimaging use (e.g., patient and hospital characteristics, primary payment sources) were determined. Results: In 2006-2014, a weighted group of 18,146,302 patients with a primary diagnosis of non-traumatic headache visited US EDs. Advanced neuroimaging utilization increased from 18.6% (n = 350,777) to 34.8% (n = 756,895) in the total group, from 18.8% (n = 314,646) to 36.5% (n = 698,080) in the adult subgroup (+94.1%), and from 16.9% (n = 36,131) to 22.0% (n = 58,815) (+30.2%) in the pediatric subgroup (+87.0%) between 2006 and 2014. The strongest predictors of higher neuroimaging utilization were hospital location in the Northeast (OR 3.17, 95% CI 2.67-3.76) or South (OR 2.42, 95% CI 2.03-2.88) regions. Lower utilization of imaging was associated with weekend ED visits (OR 0.92, 95% CI 0.92-0.93), female gender (OR 0.82, 95% CI 0.81-0.83), and Medicare, Medicaid, or self-pay (vs. private insurance) encounters. Conclusion: Neuroimaging utilization in patients with headache in US EDs nearly doubled in 2006-2014, and was used in 34.8% of all ED encounters in 2014. Utilization was higher and increased at faster rates for adults than children. In US EDs, imaging for headache is preferentially performed on commercially insured and male patients, How to cite this article: Trofimova AV, Duszak R, Kadom N, Sadigh G. Increasing and disparate use of neuroimaging for adults and children with non-traumatic headaches in the US emergency departments: Opportunities for improvement.

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“…51 The use of cross-institutional standardized 24/7/365 care pathways might be one of the potential solutions to eliminating disparities. 52 Our results suggest that despite the exist-…”

Section: Ta B L Ementioning

confidence: 67%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 91%

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Increasing and disparate use of neuroimaging for adults and children with non‐traumatic headaches in the US emergency departments: Opportunities for improvement

et al. 2020

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“…75 At the Vancouver General Hospital researchers evaluated pilot projects offering 24 hours a day, 7 days a week, 365 days a year coverage by an attending radiologist to understand the impact of expanding services on ED length of stay, disposition time, and other outcomes that affect patient flow through the ED. [115][116][117] Optimizing ED Return Visits for Ultrasound Services A Because access to after-hours services is often limited, ED physicians may have patients return to the ED for next-day ultrasound services. With the goal of reducing return visits for next-day ultrasound by 50% over 6 months, researchers in Saskatchewan developed and implemented a new clinical pathway help guide physicians to determine the appropriate location (e.g., community ultrasound clinics) and timing of ultrasound services.…”

Section: Limited Inpatient Workforcementioning

confidence: 99%

Interventions Intended to Alleviate Emergency Department Overcrowding

Mason,

Secord,

MacDougall

2023

cjht

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Why Is This an Issue? Emergency department (ED) overcrowding is a known issue in Canada that puts patients’ lives and health at risk when treatment needs within the ED exceed the resources required to address them. The causes and consequences of ED overcrowding are complex, varied, and extend beyond the ED. Left unchecked, ED overcrowding contributes to a deteriorating standard of care as staff become overworked and burned out. What Are the Potential Interventions to Address ED Overcrowding? This roundup of 87 new and emerging interventions intended to alleviated ED overcrowding complements CADTH’s Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions. Interventions were included in this report if they are not captured in CADTH’s complimentary report Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions because they are either new or are not yet in wide use in EDs and health systems across Canada and could be reasonably be expected to affect ED overcrowding (e.g., by improving patient flow through the ED or reducing the number of people seeking care in the ED). Interventions that could address multiple causal factors (e.g., e-consult services) were also included. What Is the Potential Impact? Decreasing ED overcrowding has the potential to improve the standard of care delivered to those accessing EDs and contribute to decreasing the burden on ED staff, regardless of the intervention or which contributing factor it aims to act upon. Some interventions that can alleviate ED overcrowding also have an impact on primary and community care; bolstering preventive care, increasing access to diagnostic testing for those who need it, and improving access to health care supports can improve health outcomes. What Else Do We Need to Know? The pan-Canadian issue of ED overcrowding calls for real solutions. CADTH is examining the evidence and expert-informed considerations and producing a series of publications about the causes and consequences of, and solutions to, ED overcrowding in health care systems across the country. The interventions identified in this report may be of interest to senior health care decision-makers who are anticipating health system innovation and transformation.

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Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time of Trauma-Related Imaging Studies Being Finalized Within 48 Hours in an Emergency Radiology Department, Offering a Perspective from a Tertiary Care Hospital

Cited by 2 publications

References 21 publications

Increasing and disparate use of neuroimaging for adults and children with non‐traumatic headaches in the US emergency departments: Opportunities for improvement

Increasing and disparate use of neuroimaging for adults and children with non‐traumatic headaches in the US emergency departments: Opportunities for improvement

Interventions Intended to Alleviate Emergency Department Overcrowding

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