Keywords:
Health policy and practice, Ultrasound, CT, Emergency, Audit and standards, Workforce
Authors:
A. Murchison, M. Chen, P. C. Lyon, S. Rehman, D. Grant, S. Gargalas, S. A. Nazir; Oxford/UK
DOI:
10.26044/ecr2019/C-2253
Aims and objectives
Demand for radiological imaging has increased inexorably over recent years [1,2].
Prior to our study,
we had noticed a trend of increasing number of scans being reported by the on-call registrars in our department.
We therefore investigated long-term trends in out-of-hours reporting of inpatient CTs and ultrasounds at our institution and sought to improve registrar satisfaction and workflow management.
At our hospital trust the out-of-hours radiology service,
covering three principle hospitals (including a major trauma centre),
is predominantly provided by senior registrars (third year of radiology training or above). During weekdays the out of hours radiology service is supported by on site registrars in the evenings (1700- 2100,
Figure 1) and a single senior registrar over night (2100- 0900). Weekend days (0900 to 2100) are covered by two senior and one junior registrar and weekend nights have a single senior registrar. CT scans are verified by radiology consultants within 24 hours.
Sub-speciality radiology consultants (cross-sectional,
neuroradiology,
paediatric,
musculoskeletal and interventional) are available by telephone every day of the week after hours (1700- 0900),
and a cross-sectional consultant is also resident to support weekend days (0900 to 1800) with both first and second reporting of CT.
We predicted that we could increase trainee satisfaction and improve workflow by increasing the number of trainees on duty during an evening shift (1700-2100).
We also predicted that demand for out-of-hours imaging would have increased significantly over a ten-year period,
in line with national trends.