Preston C A, Marr J J, Amaraneni K K, Suthar B S
Section of Emergency Medicine, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.
Am J Emerg Med. 1998 Mar;16(2):160-2. doi: 10.1016/s0735-6757(98)90036-5.
Retrospective and prospective chart review was conducted to study patient callbacks to the emergency department (ED) based on plain radiograph interpretation discrepancies between radiologists and emergency physicians before and after a continuous quality improvement (CQI) intervention. Patients who were called back to the ED because of radiograph interpretation discrepancies were retrospectively studied. These results were reviewed by a CQI team, which recommended greater communication and consultation. A prospective study was then performed. Before quality intervention, 0.7% of the patients were recalled; 0.4% required recall after quality assurance, a reduction of 42.9% (P = .0001). Emergency physicians in this study had a low percentage of patient recall due to discrepancies in radiologic interpretation. CQI further reduced this percentage. The proficiency of emergency physicians interpreting radiographs validates the current practice of emergency physicians rendering treatment based on their interpretations and supports the notion of emergency physicians billing for this service.
通过回顾性和前瞻性病历审查，研究了在持续质量改进（CQI）干预前后，基于放射科医生和急诊科医生对普通X线片解读差异而召回患者至急诊科（ED）的情况。对因X线片解读差异而被召回至急诊科的患者进行了回顾性研究。这些结果由一个CQI团队进行审查，该团队建议加强沟通和会诊。随后进行了一项前瞻性研究。在质量干预前，0.7%的患者被召回；质量保证后，0.4%的患者需要召回，降低了42.9%（P = .0001）。本研究中，由于放射学解读差异导致患者召回的比例较低。CQI进一步降低了这一比例。急诊科医生解读X线片的熟练程度证实了急诊科医生根据其解读进行治疗的现行做法，并支持急诊科医生为此项服务计费的观点。
