Master of Science Degree Programme, of Health and Wellness Sciences, Cape Peninsula University of Technology (CPUT), Bellville, Cape Town, South Africa.
Diagnostic Radiography, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, Cape Town, South Africa.
J Med Imaging Radiat Sci. 2020 Sep;51(3):470-479. doi: 10.1016/j.jmir.2020.06.007. Epub 2020 Jul 10.
Emergency departments in South African public hospitals have a high patient load after hours, with inadequate numbers of health care professionals available to satisfy patient influx. In addition, there is often no provision of after-hours diagnostic reporting services in public hospitals, to an extent that the emergency physician is responsible for interpreting all radiographic images requested themseves. Emergency physicians, in this study, can be described as any medical doctor registered with the Health Professions Council of South Africa and working in the emergency department as a registrar or consultant physician because there were no physicians specialized in emergency medicine working at the hospitals selected for this study.
The aim of this study was to determine the views of emergency physicians on whether there is a need for an after-hours diagnostic radiological reporting service in selected public hospitals in KwaZulu-Natal Province, South Africa.
A descriptive cross-sectional quantitative research design was utilized, through means of a survey, to assess the emergency physicians' perceptions regarding the need for after-hours diagnostic radiological reporting. In addition, the study used a descriptive quantitative research design to record the number of conventional diagnostic radiographic examinations performed at the selected hospitals, after hours, and the proportional number of these radiographic examinations that were reported on by radiologists during office hours, the following day. The distribution of questionnaires and data collection, with regard to the number of examinations reported on, and those not reported on, were carried out simultaneously during the execution of this study. The study was conducted over a three-month period in 2017, at four public hospitals in KwaZulu-Natal-one of the nine provinces of South Africa.
This study found that, during the study period, between 0.1% and 0.6% of the conventional diagnostic radiographic examinations performed, after hours, were reported on by radiologists during office hours, the following day. The surveyed emergency physicians felt that the interpretation of diagnostic images took up valuable time that could be spent on patient management, and there was near-total agreement, whereby 92% (n = 36) of the physicians would have preferred after-hours reporting to be performed by a radiologist. Physicians agreed that having a radiologist or reporting radiographer to provide radiological reports would allow for more effective and efficient patient management.
The results of this study indicated that there is a need for after-hours radiographic reporting at the selected public hospitals and for the further training of emergency physicians in radiographic image interpretation. Based on the findings of this study, it is recommended that after-hours radiological reporting services be considered for public hospitals and that courses be offered to emergency physicians on the interpretation of diagnostic radiographic images. A hospital policy review may therefore be needed to adjust the focus of hospitals toward reducing the workload of emergency physicians, wherever possible, such as by incorporating support services like radiographic reporting and by providing further training on the interpretation of diagnostic radiographic images, which will both act to reduce the potential risk of misdiagnosis.
南非公立医院的急诊科在非工作时间有大量的病人，可用的医疗保健专业人员数量不足，无法满足病人的涌入。此外，公立医院通常没有提供非工作时间的诊断报告服务，以至于急诊医生需要自行解释所有要求的放射图像。在这项研究中，急诊医生可以被描述为任何在南非健康职业委员会注册并在急诊科担任住院医师或顾问医师的医生，因为在为这项研究选择的医院中没有专门从事急诊医学的医生。
本研究旨在确定急诊医生对南非夸祖鲁-纳塔尔省选定公立医院是否需要非工作时间诊断放射学报告服务的看法。
采用描述性横断面定量研究设计，通过调查评估急诊医生对非工作时间诊断放射学报告需求的看法。此外，该研究还采用描述性定量研究设计，记录选定医院下班后进行的常规诊断放射学检查数量，以及放射科医生在次日工作时间内报告的这些放射学检查的比例。在执行本研究期间，同时进行了问卷调查和报告数量的数据收集。
本研究发现，在研究期间，下班后进行的常规诊断放射学检查中，有 0.1%至 0.6%是由放射科医生在次日工作时间内报告的。接受调查的急诊医生认为，诊断图像的解释占用了宝贵的时间，可以用于患者管理，几乎完全达成一致，92%（n=36）的医生更希望非工作时间的报告由放射科医生来完成。医生们一致认为，有放射科医生或报告放射技师提供放射学报告，可以实现更有效的患者管理。
这项研究的结果表明，选定的公立医院需要非工作时间的放射报告，并且需要进一步培训急诊医生进行放射图像解读。基于这项研究的结果，建议考虑为公立医院提供非工作时间的放射学报告服务，并为急诊医生提供诊断放射图像解读课程。因此，可能需要对医院政策进行审查，以调整医院的重点，尽可能减少急诊医生的工作量，例如纳入放射报告等支持服务，并提供诊断放射图像解读的进一步培训，这将有助于降低误诊的潜在风险。
