AN AUDIT OF STAT REPORTS OF EMERGENCY AND IPD CASES BY RESIDENTS DURING ON CALL HOURS AND COMMUNICATION OF CRITICAL FINDINGS

Abstract

Descriptor: 

An audit to see whether the stat reports by residents during on call hours are concordant or discordant with the final verified reports by the consultant radiologist and were the critical findings conveyed to primary team on time.  

Background:

Shifa international hospital is a quaternary care facility with 550 beds providing quality care to local as well as international patients for the last 50 years. Department of Radiology house the latest equipment and technologies under the supervision of an experienced and qualified team consisting of Neuro, Interventional and diagnostic radiologists as well as ultrasound physicians and technical staff. During the official timings from 9 am to 5 pm residents work under direct supervision of respective consultants and report emergency, outpatient department (OPD) and inpatient department (IPD) cases. And after that, during on call hours, after proper training, DOPS (direct observation of procedural skills), stat sessions and approval of privileges from PGMI (post graduate medical Institute), residents are allowed to put stat reports of emergency, IPD and OPD patients with critical findings. An on call consultant radiologist supervises them during these hours.

Our on call team consists of three residents: senior most, junior 1 and junior 2 to put stat reports of MRI, CT and radiographs respectively and convey the critical findings to primary team with documentation on RIS (radiology information system). On the next day their reports are verified by the consultant radiologists. Discrepancies between stat report and final verified report will be highlighted in this audit quantitatively. It will further be assessed that were the critical findings were conveyed to primary team timely as per the set policy of hospital or not.

After receiving a number of reports of patient harm due to failed communication in 2007 the National Patient Safety Agency (NPSA) published safer practice notice 16, “Early identification of failure to act on radiological imaging reports” [1]. The idea behind the audit was from RCR Guidelines on communication of critical, urgent and unexpected significant radiological findings. [2-4]