On-Call Radiology Resident Discrepancies: Categorization by Patient Location and Severity

详细信息    查看全文

• 作者：Vincent Mellnick ; MD ; ^{mellnickv@wustl.edu" class="auth_mail" title="E-mail the corresponding author} ; Constantine Raptis ; MD ; Sebastian McWilliams ; MD ; Daniel Picus ; MD ; Richard Wahl ; MD
• 关键词：Resident ; discrepancies ; patient contact ; discharged ; patient location
• 刊名：Journal of the American College of Radiology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：13
• 期：10
• 页码：1233-1238
• 全文大小：135 K

文摘

To report discrepancy rates for examinations interpreted by on-call residents overall and by resident training level, and to describe a novel discrepancy classification system based on patient location and severity that facilitates recording of discrepancy data, helps ensure proper communication of report changes, and allows our radiology department to assume responsibility for contacting discharged patients with non-time-dependent results.

Methods

A HIPAA-compliant, institutional review board–exempt review of two years (January 2013 to December 2014) of discrepancy data was retrospectively performed for total number of examination interpreted, discrepancy rates, resident training level, and discrepancy categories. Most common diagnoses and means of results communication for discharged patients were also recorded.

Results

Radiology residents interpreted 153,420 examinations after hours and had 2169 discrepancies, for an overall discrepancy rate of 1.4%. Discrepancy rates for postgraduate year (PGY)-3, PGY-4, and PGY-5 residents were 1.31%, 1.65%, and 1.88%, respectively. The rate of critical discrepancies was extremely low (10/153,420 or 0.007%). A total of 502 patients (23.2% of all discrepancies) were discharged at the time their discrepancy was identified, 60% of whom had non-time-dependent discrepancies that were communicated by radiologists; 32.4% of these had addended results telephoned to a PCP, 43.4% had addended results telephoned to the patient, and the remaining 24.2% required a registered letter. Eight percent of patients with non-time-dependent findings were lost to follow-up.

Conclusions

Our resident discrepancy rates were comparable to those published previously, with extremely low rates of critical discrepancies. Radiologists assumed responsibility for contacting the majority of discharged patients with discrepant results, a minority of whom were lost to follow-up.