Staggered Radiologist Work Shifts Shown to Improve Patient Care

Implementation of staggered radiologist work shifts can expedite the communication of urgent findings and improve patient care, according to a recent study.

Radiology practice in the United States is moving toward 24-hour/7-day coverage, in which it has maximized coverage for imaging such as magnetic resonance imaging (MRI) and computed tomography (CT) interpretation either by utilizing on-call radiologists with their groups or teleradiology services. However, in many institutions, there is incomplete coverage for interpretation of other imaging such as conventional X-rays, particularly for overnight and early morning hours.

The study, performed at Massachusetts General Hospital and Harvard Medical School, both in Boston, MA, USA, included 6,448 portable X-ray exams that were performed during an early morning radiologist shift. Urgent findings requiring immediate communication were identified in 308 studies. "The early morning shift of radiologists, on average, communicated these findings two hours earlier as compared to our control group," said Rathachai Kaewlai, M.D., lead author of the study. The average elapsed time from image acquisition to the communication of urgent results was 340 minutes in the study group and 457 minutes in the control group.

"Prompt communication of findings that suggest a need for immediate or urgent medical intervention among healthcare professionals is very important for accurate and timely case management, which can potentially affect patient outcome," said Dr. Kaewlai. "Our results support the concept that staggered radiologist work shifts have the potential to expedite the communication of urgent findings and improve patient care. Imaging departments need to periodically reassess their staff coverage with a view to providing timelier image interpretation, and communication of imaging results, particularly urgent or critical findings."

The study's findings were published in the September 2010 issue of the Journal of the American College of Radiology.

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Massachusetts General Hospital
Harvard Medical School