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Audit of the change in the on-call practices in neuroradiology and factors affecting it.

Mukerji N, Wallace D, Mitra D - BMC Med Imaging (2006)

Bottom Line: This audit was conducted to assess any change in the departmental workload as a result of this change.Although this was not statistically significant due to lack of study power, it is clinically relevant.Other factors such as clinician seniority and a greater awareness of the NICE guidelines may have also contributed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Newcastle General Hospital, Newcastle-upon-Tyne, NE4 6BE, UK. mukerji@doctors.org.uk

ABSTRACT

Background: On call practices had recently changed at the Newcastle General Hospital to accommodate increasing CT scan requests and reduce the workloads of the radiologists. In the new system, the person responsible for dealing with the out of hours requests for imaging changed from the neuroradiologist to the neuroradiographer. This audit was conducted to assess any change in the departmental workload as a result of this change.

Methods: The audit was carried out over a period of six months and data was collected from the on-call booklets which the neuroradiographers maintained and the log books maintained in the department of neuroradiology. Details of the imaging requested; the source of the request, the reason for the request and the results of the scans were recorded and analysed using Microsoft Excel.

Results: The number of CT scans requested from the A&E went up by 73.4% after the change in practice and majority of these increases were due to increased requests for scans on head injuries which increased by 122%. Although this was not statistically significant due to lack of study power, it is clinically relevant.

Conclusion: The increase in the number of CT scans for head injuries reflects a general change in practice in management of head injuries in the UK. Changing the gatekeeper from radiologist to radiographer was associated with an increase in CT rate, particularly for head injuries. Other factors such as clinician seniority and a greater awareness of the NICE guidelines may have also contributed.

No MeSH data available.


Related in: MedlinePlus

A diagrammatic representation of the break-up of the examinations performed between 15/1/04 to 15/4/04 (n = 507).
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Figure 1: A diagrammatic representation of the break-up of the examinations performed between 15/1/04 to 15/4/04 (n = 507).

Mentions: Data for the overall work pattern was collected from the on-call booklets. A total of 507 examinations were performed over 74 days during the study period in which the on-call booklets were introduced ie. 15/1/04 to 15/4/04. Average number of examinations out-of-hours were 6.8 per day with a range from 1 to 18. Out of all these examinations, 90 were performed between midnight and 7 am resulting in an average of 1.2 calls per night. CT head scans accounted for 66% of the total workload with plain x-rays accounting for 21%, MRI 7%, CT spine 4% and diagnostic angiography 2% (Figure 1). A total of 336 CT head scans were performed out of hours in this period (mean 4.5/day, range 1–11). A&E department accounted for the maximum, 62% of the total number of CT requests. The neurosciences departments accounted for 29% and the others for 9%.


Audit of the change in the on-call practices in neuroradiology and factors affecting it.

Mukerji N, Wallace D, Mitra D - BMC Med Imaging (2006)

A diagrammatic representation of the break-up of the examinations performed between 15/1/04 to 15/4/04 (n = 507).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1622746&req=5

Figure 1: A diagrammatic representation of the break-up of the examinations performed between 15/1/04 to 15/4/04 (n = 507).
Mentions: Data for the overall work pattern was collected from the on-call booklets. A total of 507 examinations were performed over 74 days during the study period in which the on-call booklets were introduced ie. 15/1/04 to 15/4/04. Average number of examinations out-of-hours were 6.8 per day with a range from 1 to 18. Out of all these examinations, 90 were performed between midnight and 7 am resulting in an average of 1.2 calls per night. CT head scans accounted for 66% of the total workload with plain x-rays accounting for 21%, MRI 7%, CT spine 4% and diagnostic angiography 2% (Figure 1). A total of 336 CT head scans were performed out of hours in this period (mean 4.5/day, range 1–11). A&E department accounted for the maximum, 62% of the total number of CT requests. The neurosciences departments accounted for 29% and the others for 9%.

Bottom Line: This audit was conducted to assess any change in the departmental workload as a result of this change.Although this was not statistically significant due to lack of study power, it is clinically relevant.Other factors such as clinician seniority and a greater awareness of the NICE guidelines may have also contributed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Newcastle General Hospital, Newcastle-upon-Tyne, NE4 6BE, UK. mukerji@doctors.org.uk

ABSTRACT

Background: On call practices had recently changed at the Newcastle General Hospital to accommodate increasing CT scan requests and reduce the workloads of the radiologists. In the new system, the person responsible for dealing with the out of hours requests for imaging changed from the neuroradiologist to the neuroradiographer. This audit was conducted to assess any change in the departmental workload as a result of this change.

Methods: The audit was carried out over a period of six months and data was collected from the on-call booklets which the neuroradiographers maintained and the log books maintained in the department of neuroradiology. Details of the imaging requested; the source of the request, the reason for the request and the results of the scans were recorded and analysed using Microsoft Excel.

Results: The number of CT scans requested from the A&E went up by 73.4% after the change in practice and majority of these increases were due to increased requests for scans on head injuries which increased by 122%. Although this was not statistically significant due to lack of study power, it is clinically relevant.

Conclusion: The increase in the number of CT scans for head injuries reflects a general change in practice in management of head injuries in the UK. Changing the gatekeeper from radiologist to radiographer was associated with an increase in CT rate, particularly for head injuries. Other factors such as clinician seniority and a greater awareness of the NICE guidelines may have also contributed.

No MeSH data available.


Related in: MedlinePlus