Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Emergency Radiology, 111 East 210 Street, Bronx, NY, 10467, USA.
Emerg Radiol. 2023 Apr;30(2):153-159. doi: 10.1007/s10140-022-02110-9. Epub 2022 Dec 22.
In academic radiology departments, attendings and resident are increasingly working together overnight for Emergency Department (ED) radiology coverage. The purpose of this study was to quantify reporting turnaround time for overnight cases read by residents and for overnight shifts with residents on duty.
A retrospective study was performed at a hospital system where one overnight attending covers two hospitals with a 2nd/3rd year overnight resident, and a second overnight attending covers two other hospitals 80% of the time independently and 20% of the time with a fourth-year resident. In the first analysis, the median difference in turnaround time, from the time when the case was completed by the technologist to the time the attending finalized it, between cases read independently by attendings and cases pre-dictated by residents was calculated. In the second analysis, the median difference in turnaround time for all cases performed at the second two hospitals was compared on nights when an attending was on duty alone versus nights when a fourth-year resident was also on duty, regardless of if the resident had pre-dictated the case.
For computed tomography (CT), radiographs (XR), and ultrasound (US), there was a significant delay in turnaround time for cases pre-dictated by residents compared to cases read independently by attendings, ranging between 11 and 49 min depending on resident seniority and modality (p ≤ 0.001). For all cases on nights with a 4th year resident working, overall median report turnaround time decreased by 7 min (p < 0.001).
Resident pre-dictation causes delay in the finalization of individual CT, US, and XR reports; however, overall, working with residents results in a significant decrease in report turnaround time supporting the belief that overnight resident education does not delay patient care.
在学术放射科，主治医生和住院医师越来越多地一起值夜班，为急诊科（ED）放射科提供服务。本研究的目的是量化由住院医师阅读的夜间病例和有住院医师值班的夜间轮班的报告周转时间。
本研究在一家医院系统中进行，该系统中有一位夜间主治医生负责两个医院，一位 2/3 年级的夜间住院医师，另一位夜间主治医生 80%的时间独立负责两个其他医院，20%的时间与四年级住院医师一起负责。在第一次分析中，计算了主治医生独立阅读病例和住院医师预打字病例之间完成技师完成病例到主治医生最终完成病例之间的周转时间中位数差异。在第二次分析中，比较了第二位两个医院的所有病例在夜间主治医生单独值班与夜间四年级住院医师也值班的情况下，无论住院医师是否预打字，其周转时间中位数差异。
对于计算机断层扫描（CT）、放射线照相术（XR）和超声（US），与主治医生独立阅读病例相比，住院医师预打字病例的周转时间明显延迟，延迟时间因住院医师的级别和模式而异，范围在 11 至 49 分钟之间（p ≤ 0.001）。在有四年级住院医师工作的所有夜间病例中，整体报告周转时间中位数减少了 7 分钟（p < 0.001）。
住院医师预打字会导致个别 CT、US 和 XR 报告的最终完成延迟；然而，总的来说，与住院医师一起工作会显著缩短报告周转时间，这支持了夜间住院医师教育不会延迟患者护理的观点。
