Markowitz R I, Meyer J S, Hegman J A, Fellows K E
Department of Radiology, Children's Hospital of Philadelphia, PA 19104, USA.
Pediatr Radiol. 1998 Mar;28(3):167-70. doi: 10.1007/s002470050321.
In order to achieve more "timely" interpretation of radiologic examinations, a 3 to 11 p.m. attending radiologist slot was incorporated into the daily schedule utilizing existing staff. Our purpose was to assess the effectiveness of this practice by measuring report generation times.
Using a radiology information system (DecRAD), the time between completion of the technical examination and dictation of the official report for general (plain film) studies was determined for a 2-month period and compared to similar periods 1 and 2 years prior to instituting extended hours. Emergency and portable (ICU) exams were similarly analyzed.
The number of examinations reported within 2 h of technical completion increased by 8.5% (mean); reporting within 4 h increased by 20%; reporting within 6 and 12 h of completion each increased by 24%. Over 80% of cases were dictated within 12 h after the change in practice occurred; whereas, it took up to 24 h in preceding years. Analysis of emergency and portable ICU exams showed similar trends, and the number of next day "call-backs" to the emergency department was significantly reduced.
By extending attending coverage, more plain film examinations, especially emergency cases and ICU portables, were read and reported within a shorter time providing prompt communication with clinicians and more opportunity to influence management decisions.
为了实现对放射学检查更“及时”的解读，利用现有工作人员在每日工作安排中增设了下午3点至晚上11点的主治放射科医生值班时段。我们的目的是通过测量报告生成时间来评估这种做法的有效性。
使用放射学信息系统（DecRAD），确定了为期2个月的普通（平片）检查技术检查完成至正式报告听写之间的时间，并与延长工作时间前1年和2年的类似时间段进行比较。对急诊和便携式（重症监护病房）检查进行了类似分析。
技术完成后2小时内报告的检查数量平均增加了8.5%；4小时内报告的增加了20%；完成后6小时和12小时内报告的各增加了24%。超过80%的病例在实践改变后12小时内完成听写；而在前几年，这需要长达24小时。对急诊和便携式重症监护病房检查的分析显示了类似趋势，并且返回急诊科的次日“回访”数量显著减少。
通过扩大主治医生的覆盖范围，更多的平片检查，尤其是急诊病例和重症监护病房的便携式检查，在更短的时间内得到解读和报告，从而与临床医生进行及时沟通，并有更多机会影响管理决策。
