Physician assessments of practice patterns in emergency department radiograph interpretation

O'Leary, Margaret; Smith, Mark S.; Olmsted, William W.; Curtis, David

doi:10.1016/s0196-0644(88)80438-4

Cited by 38 publications

(8 citation statements)

References 6 publications

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“…Brunswick et al have reported a 1% discrepancy rate, and 0.47% CSD rate for all plain film radiographs 3. Recently, there has been a decreasing trend in the discrepancy rates, with overall discrepancy rates and clinically significant misinterpretation rates of 1–6% and 0.1–3%, respectively, being reported 3 8 11…”

Section: Discussionmentioning

confidence: 99%

Radiological misinterpretations by emergency physicians in discharged minor trauma patients

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Radiological misinterpretations by emergency physicians in discharged minor trauma patients

et al. 2011

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“…This situation conformed to O'Leary et al's assessment of practice patterns in the interpretation of radiographs in emergency departments: “The interhospital variability of responsibilities within the course of a 168-hour week suggest that the evolution of these arrangements may have been driven by staffing constraints, scheduling practices and convenience, rather than by efforts to provide a consistent high standard of care.”9…”

Section: Case Studymentioning

confidence: 99%

Reducing errors made by emergency physicians in interpreting radiographs: longitudinal study

Espinosa

2000

BMJ

146

107

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Objectives To reduce errors made in the interpretation of radiographs in an emergency department. Design Longitudinal study. Setting Hospital emergency department. Interventions All staff reviewed all clinically significant discrepancies at monthly meetings. A file of clinically significant errors was created; the file was used for teaching. Later a team redesigned the process. A system was developed for interpreting radiographs that would be followed regardless of the day of the week or time of day. All standard radiographs were brought directly to the emergency physician for immediate interpretation. Radiologists reviewed the films within 12 hours as a quality control measure, and if a significant misinterpretation was found patients were asked to return. Main outcome measures Reduction in number of clinically significant errors (such as missed fractures or foreign bodies) on radiographs read in the emergency department. Data on the error rate for radiologists and the effect of the recall procedure were not available so reliability modelling was used to assess the effect of these on overall safety.

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Section: Introductionmentioning

confidence: 99%

“…Therefore, the relationship between emergency medicine (EM) and radiology may have a substantial impact on patient flow and quality of care in EDs. Although the relationship between EM and radiology at individual institutions has been studied, [1][2][3][4][5] there are no systematic data on national patterns.The purpose of this study was to determine how EM and radiology work together at institutions with EM residencies in the United States. A survey was sent to all U.S. EM residency programs to determine the availability of radiologists, who interprets radiographs, how information is transmitted between EPs and radiologists, the frequency of misread images, and EPs' satisfaction with radiology services.…”

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confidence: 99%

Radiology Services in Emergency Medicine Residency Programs: A National Survey

Lowe

Abbühl

Baumritter

et al. 2002

Academic Emergency Medicine

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Objectives: To determine who reads plain film radiographs, how quickly radiologists' interpretations are available, how many initial readings require correction, and how satisfied emergency physicians (EPs) are with radiology in emergency departments (EDs) with emergency medicine (EM) residency programs. Methods: A questionnaire was sent to the chairs of all U.S. EM residencies, asking about EM radiology services. Results: Of 120 sites surveyed, 97 (81%) responded. Respondents reported that, on weekday days, EM attendings or residents performed the radiograph interpretation used for clinical decision making at 66% of sites; on nights and weekends, EPs performed the clinically relevant readings at 79% of sites. Twenty-one percent of sites reported that no radiologist reviewed images before patients left the ED on nights and weekends. Only 39% of sites reported that all images were read within four hours on weekday days, and only 19% of sites reported readings within this time frame on nights and weekends. Median misinterpretation rates were reported as 1% on weekday days and 1.5% at other times. Overall, EPs were satisfied with their interactions with radiology at 63% of EDs. Conclusions: This study summarizes the perceptions of EPs regarding radiology services; the findings must be interpreted with caution, given the lack of external validation. Nevertheless, EPs report that many EM residency programs depend on EPs' interpretations of radiographs. Emergency physicians report that attending radiologists rarely read images on nights and weekends and that images are misread more frequently at these times. Although EPs were satisfied with many aspects of radiology, EPs expressed the most dissatisfaction with turnaround times and misreads. Key words: radiology; radiographs; x-rays; emergency medicine; residency. ACADEMIC EMERGENCY MEDICINE 2002; 9:587-594. Although many patients treated in the emergency department (ED) are managed solely by emergency physicians (EPs), a substantial number of patients require consultation with other specialists. At best, these consultations lead to good clinical outcomes, aided by ready availability of specialists and good communication among physician colleagues. At worst, consultations may lead to delays and poor communication, resulting in dissatisfied patients, frustrated clinicians, and increased potential for medical errors. Optimizing the relationship between EPs and consultants may be particularly challenging in teaching hospitals, where residents serving as consultants may function with varying degrees of supervision by their attendings.In many EDs, radiologists are probably the most commonly consulted physicians. A large proportion of ED patients receive radiographs, and in many EDs all radiographs are interpreted by radiologists. Therefore, the relationship between emergency medicine (EM) and radiology may have a substantial impact on patient flow and quality of care in EDs. Although the relationship between EM and radiology at individual institutions has been st...

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Physician assessments of practice patterns in emergency department radiograph interpretation

Cited by 38 publications

References 6 publications

Radiological misinterpretations by emergency physicians in discharged minor trauma patients

Radiological misinterpretations by emergency physicians in discharged minor trauma patients

Reducing errors made by emergency physicians in interpreting radiographs: longitudinal study

Radiology Services in Emergency Medicine Residency Programs: A National Survey

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