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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 change in referral patterns over the two three month periods included in the study.
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Figure 2: A diagrammatic representation of the change in referral patterns over the two three month periods included in the study.

Mentions: This was assessed on the basis of CT head requests before and after the introduction of the new system. This data was collected from the CT scan suite logbook and had no missing data. The total number of CT scan requests from A&E had gone up from 158 before the change to 274 after the change, an increase of 73.4% (p = 0.17, 95% CI of difference of mean -520 to +952). This included all CT head requests from A&E, head injuries and otherwise. In the corresponding period the number of CT head requests from the neurosciences department went down from 173 before the change to 146 after the change, a decrease of 15.6% (p = 0.054, 95% CI of difference of mean -12 to +331). CT scans performed from head injuries from the A&E increased from 66 in the period between 15/10/03 to 14/1/04 to 147 between 15/1/04 and 15/4/04 an increase of 122% (p = 0.23, 95% CI of difference of mean -408 to +621) (Figure 2).


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 change in referral patterns over the two three month periods included in the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: A diagrammatic representation of the change in referral patterns over the two three month periods included in the study.
Mentions: This was assessed on the basis of CT head requests before and after the introduction of the new system. This data was collected from the CT scan suite logbook and had no missing data. The total number of CT scan requests from A&E had gone up from 158 before the change to 274 after the change, an increase of 73.4% (p = 0.17, 95% CI of difference of mean -520 to +952). This included all CT head requests from A&E, head injuries and otherwise. In the corresponding period the number of CT head requests from the neurosciences department went down from 173 before the change to 146 after the change, a decrease of 15.6% (p = 0.054, 95% CI of difference of mean -12 to +331). CT scans performed from head injuries from the A&E increased from 66 in the period between 15/10/03 to 14/1/04 to 147 between 15/1/04 and 15/4/04 an increase of 122% (p = 0.23, 95% CI of difference of mean -408 to +621) (Figure 2).

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