Staggered radiologist work shifts improve patient care, study suggests

Implementation of staggered radiologist work shifts can expedite the communication of urgent findings and improve patient care, according to a study in the September issue of the Journal of the American College of Radiology.

Radiology practice in the United States is moving toward 24/7 coverage, in which it has maximized coverage for imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) 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, especially for overnight and early morning hours.

The study, performed at Massachusetts General Hospital and Harvard Medical School in Boston, MA, included 6,448 portable X-ray exams that were performed during an early morning radiologist shift. Urgent findings requiring immediate communication were detected 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, MD, lead author of the study. The mean 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 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 re-assess their staff coverage with a view to providing timelier image interpretation, and communication of imaging results, particularly urgent or critical findings," he said.