Congress:
EuroSafe Imaging 2018
Keywords:
Audit and standards, CT, Abdomen, Action 6 - Clinical audit tool for imaging, Action 2 - Clinical audit, Acute
Authors:
K. Drinkwater, D. Howlett, C. Frost, A. Higginson, C. Ball, G. Maskell
DOI:
10.1594/esi2018/ESI-0073
Background/introduction
Abdominopelvic computed tomography (CT) can be challenging to report,
particularly in patients who are acutely unwell.
A rapid increase in utilisation of CT,
particularly out of hours,
has created reporting pressures within United Kingdom (UK) radiology departments,
and this has led to the development of different reporting models:
- Provisional (initial) CT reports may be issued by trainee radiologists (registrars) with subsequent review by senior onsite consultant radiologists
- Reports may be issued by consultants themselves
- Reporting may be carried out by radiologists working offsite with no affiliation to the department where the imaging occurs.
Offsite reporters are typically of consultant level or equivalent,
but may not be trained or working within the UK. Offsite reporting is particularly utilised out of hours,
a practice that is well recognised across Europe and North America.
Both registrar and offsite reports may be supplemented by an addendum (supplementary) report provided later by an onsite consultant.
Alongside these variations in practice has been recognition of the concept of radiological “error” or “discrepancy” and the relationship of a discrepant report to potential or actual harm to the patient1,2.
The aims of this national,
UK-wide audit on acute non-traumatic abdominopelvic CT reporting in surgical and non-surgical groups were:
- To assess major/minor discrepancy rates for provisional and also addendum reports
- To examine factors affecting major discrepancy rate at the level of the provisional report
- To examine reporting factors affecting cases of major discrepancy where patients came to harm and also to assess the nature of the harm
- To document any added value of a consultant addendum report and to evaluate the availability of provisional and addendum reports pre-operatively in the surgical group
- To document overall compliance with audit standards.