Nolan T M, Oberklaid F, Boldt D
Aust Paediatr J. 1984 May;20(2):109-12. doi: 10.1111/j.1440-1754.1984.tb00055.x.
Radiological services to the Department of Ambulatory Paediatrics were audited over 1 month. Of a total of 782 separate radiographs, more than two-thirds were performed outside hours when radiologists are normally in the hospital. For only 171 of the 782 radiographs (22%) were there immediate reports by a radiologist. To determine whether the absence of immediate radiologist reports affected clinical care, a process was introduced whereby radiologists reviewed interpretation of radiographs made by resident medical officers (RMO) when no report was available. Over a 5 month period 2888 patients had radiographs when there was no immediate radiologist's report. Comparisons were made between RMO interpretation and ultimate radiologist report in 1411 of these patients. In 232 cases (16.4%) there was a discrepancy between RMO interpretation and radiologist report; 70% of these were false positive (the RMO interpreting a normal film as abnormal) while 71 were false negative (the RMO interpreting an abnormal film as normal). This study demonstrates the utility of a relatively simple quality assurance measure in situations where clinical decisions have to be made in the absence of an immediate radiologist report.
对门诊儿科部门的放射服务进行了为期1个月的审计。在总共782张独立的X光片中，超过三分之二是在放射科医生通常不在医院的非工作时间进行的。在782张X光片中，只有171张（22%）有放射科医生的即时报告。为了确定没有放射科医生的即时报告是否会影响临床护理，引入了一个流程，即当没有报告时，放射科医生会复查住院医（RMO）所做的X光片解读。在5个月的时间里，有2888名患者在没有放射科医生即时报告的情况下进行了X光检查。对其中1411名患者的RMO解读和最终的放射科医生报告进行了比较。在232例（16.4%）病例中，RMO解读和放射科医生报告之间存在差异；其中70%为假阳性（RMO将正常片子解读为异常），而71例为假阴性（RMO将异常片子解读为正常）。这项研究表明，在没有放射科医生即时报告而必须做出临床决策的情况下，一种相对简单的质量保证措施是有用的。
