In response to increasing service demands, a change was made to radiology services at Basildon Hospital. Out-of-hours reporting of CT scans was outsourced to an external tele-radiology provider. In addition, routine in-hours CT reporting was extended by 3 hours, from 9-5pm to 9-8pm, 7 days a week. The intended benefit was to minimise delays in reporting and subsequent delays in management decisions based upon these imaging findings. Ultimately, improving patient safety was the key target. The two-part service change would also tackle the increasing demand...

This retrospective closed-loop audit used data retrieved from the Radiology Information Systems (RIS) and Picture Archiving and Communication Systems (PACS) at Basildon Hospital. Definitions In-hours - scans requested 9-5pm (prior to service change) and 9-8pm (after service change) 7 days a week Out-of-hours - any scans requested outside of the above times. Inclusion and exclusion criteria In-patient and Accident and Emergency CT scans, of any body part, were included. Exclusion was applied to any ‘Outpatient’ scans, studies transferred from other sites, thrombolysis pathway patientsand CT...

After the service change, standards werealmost met for routine scans with average reporting times improving from 32 hours 15 minutes to 24 hours 52 minutes(Fig. 1). The most significant delay, prior to the service change, was in performing the scan (request to scan completion timeaveraged 26 hours 56 minutes). With extension of routine in-hour scanning and reporting by 3 hours daily, there was alarge improvementinscanning times by approximately 8 hours average, demonstrating that CT scanning capacity was a major limiting factor in the old service...

Outsourcing out-of-hours reporting is a management strategy that can be integrated with extended working days to improve reporting times for routine and high priority CT scans.However, there are issues to be addressed to ensure high priority scans are reported in a timely fashion out-of-hours. Our recommendations include Maximise CT scanning capacity by addressing other factors which may contribute to'wasted' CT scanner capacity, for example delays in transporting the patient to the scanner. Eliminate any unnecessary time in authorising reports. Further analysis of process of interaction...

Dr Geoffrey Chow Radiology trainee at Royal Free Hospital, UK Dr John Maynard Radiology trainee at University College London Hospital, UK Dr Qaiser Malik Consultant Radiologist at Basildon Hospital, UK Dr Priti Tare Consultant Radiologist at Basildon Hospital, UK

NICE 2014 Guidelines on Adult Head Injury, last accessed 14/12/2015 at 17:35 at following address: http://www.nice.org.uk/guidance/cg176/chapter/1-recommendations