Clinical Workflow Can Threaten Resident Education

As part of a weeklong rapid improvement event at a large teaching hospital, members of the department of radiology, the department of emergency medicine, and hospital administration had gathered in a classroom to discuss etiologies and possible solutions to the problem of after-hours radiology report turnaround times that had been steadily creeping upward over the past year.

Numerous factors might have explained the increase in turnaround times. For example, over the past several years, the number of radiology department faculty members had remained nearly constant, whereas the corresponding number for the emergency department had nearly doubled. However, the focus of the meeting had settled on radiology workflow.

One of the hospital administrators asked the director of radiology to present an overview of the steps involved in the care of patients from the radiology department. In doing so, he indicated that a radiology resident is in house during all nights, weekends, and holidays, and that the on-call resident reports each study prior to review with an attending radiologist.

“And what period of time elapses between the initial interpretation by the resident and the review by the attending physician?” asked one of the emergency department faculty members?

The director of radiology explained that attending radiologists take call from home, calling in to the hospital to speak with the on-call resident and reviewing each study on a home workstation. “In general,” the director of radiology said, “the interval between initial interpretation and final review by the attending radiologist varies between 15 minutes and 2 hours.”

The emergency department faculty member asked why it could take as long as 2 hours for an emergency department study to be reviewed.

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Clinical Workflow Can Threaten Resident Education

Further Reading

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