Rawan Abu Mughli, Deyvison T Baia Medeiros, Róisín MacDermott, Jacques du Plessis, Abdelazim M E Mohammed, Jason A Robins, Sadia R Qamar, Michael E O'Keeffe, Rajesh Bhayana, Masoom A Haider, Ferco H Berger
{"title":"保留居民自主权的夜间急诊放射科医生覆盖模式：对报告周转时间和居民经验的影响。","authors":"Rawan Abu Mughli, Deyvison T Baia Medeiros, Róisín MacDermott, Jacques du Plessis, Abdelazim M E Mohammed, Jason A Robins, Sadia R Qamar, Michael E O'Keeffe, Rajesh Bhayana, Masoom A Haider, Ferco H Berger","doi":"10.1007/s10140-025-02330-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of overnight in-house emergency radiologist coverage on turnaround time (TAT) for emergent imaging of ED and inpatients, during the night and following morning, in a coverage model tailored to preserving resident autonomy.</p><p><strong>Methods: </strong>Retrospective analysis of TAT for all emergent imaging of ED and inpatients at an academic Level-1 trauma center from September 2015 to August 2019, two years before and after changing coverage model. Median and 90th percentile were assessed for overnight (22:00-07:00 h.) and morning (07:00-10:00 h.) emergent imaging TAT for both the 'First report' and 'Final report'. Statistical significance of TAT changes between study years was assessed with quantile regression. Trainee report volumes and their rotation evaluations were assessed.</p><p><strong>Results: </strong>128,433 emergent ED and inpatient imaging studies (82,482 overnight and 45,951 morning) were included; 40,136 CTs, 83,993 X-rays, 2018 US and 2286 MRIs. Imaging volumes increased over time. Except 90th percentile MRI First report TAT, all overnight TAT metrics statistically significantly improved with the new coverage model. For example, ED CT median Final report TAT decreased from 8.45 h to 1.38 h. Morning imaging showed statistically significant reduction for all TATs, except for MRI TATs and 90th percentile US Final report TAT. For example, ED CT median Final report TAT decreased from 1.56 h to 1.19 h. Absolute imaging volume reported by trainees increased by 14% in the 4-year period and weighted average rotation evaluation on a 5-point scale was 3.9 in the post-implementation cohort.</p><p><strong>Conclusion: </strong>Introduction of a tailored in-house overnight emergency radiologist coverage model can preserve resident autonomy and productivity while achieving statistically significant reduction of emergent imaging report turnaround time for emergent imaging overnight and the following morning. It may help mitigate ED overcrowding while preserving trainee educational experience.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"203-215"},"PeriodicalIF":1.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Overnight emergency radiologist coverage model with preserved resident autonomy: impact on report turnaround times and resident experience.\",\"authors\":\"Rawan Abu Mughli, Deyvison T Baia Medeiros, Róisín MacDermott, Jacques du Plessis, Abdelazim M E Mohammed, Jason A Robins, Sadia R Qamar, Michael E O'Keeffe, Rajesh Bhayana, Masoom A Haider, Ferco H Berger\",\"doi\":\"10.1007/s10140-025-02330-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the impact of overnight in-house emergency radiologist coverage on turnaround time (TAT) for emergent imaging of ED and inpatients, during the night and following morning, in a coverage model tailored to preserving resident autonomy.</p><p><strong>Methods: </strong>Retrospective analysis of TAT for all emergent imaging of ED and inpatients at an academic Level-1 trauma center from September 2015 to August 2019, two years before and after changing coverage model. Median and 90th percentile were assessed for overnight (22:00-07:00 h.) and morning (07:00-10:00 h.) emergent imaging TAT for both the 'First report' and 'Final report'. Statistical significance of TAT changes between study years was assessed with quantile regression. Trainee report volumes and their rotation evaluations were assessed.</p><p><strong>Results: </strong>128,433 emergent ED and inpatient imaging studies (82,482 overnight and 45,951 morning) were included; 40,136 CTs, 83,993 X-rays, 2018 US and 2286 MRIs. Imaging volumes increased over time. Except 90th percentile MRI First report TAT, all overnight TAT metrics statistically significantly improved with the new coverage model. For example, ED CT median Final report TAT decreased from 8.45 h to 1.38 h. Morning imaging showed statistically significant reduction for all TATs, except for MRI TATs and 90th percentile US Final report TAT. For example, ED CT median Final report TAT decreased from 1.56 h to 1.19 h. Absolute imaging volume reported by trainees increased by 14% in the 4-year period and weighted average rotation evaluation on a 5-point scale was 3.9 in the post-implementation cohort.</p><p><strong>Conclusion: </strong>Introduction of a tailored in-house overnight emergency radiologist coverage model can preserve resident autonomy and productivity while achieving statistically significant reduction of emergent imaging report turnaround time for emergent imaging overnight and the following morning. It may help mitigate ED overcrowding while preserving trainee educational experience.</p>\",\"PeriodicalId\":11623,\"journal\":{\"name\":\"Emergency Radiology\",\"volume\":\" \",\"pages\":\"203-215\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Emergency Radiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s10140-025-02330-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Radiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10140-025-02330-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/17 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估夜间住院急诊放射科医生覆盖对急诊和住院患者急诊成像周转时间（TAT）的影响，在夜间和次日早晨，在一个专门为保留住院医师自主权而设计的覆盖模型中。方法：回顾性分析2015年9月至2019年8月某创伤一级学术中心急诊急诊急诊影像及住院患者的TAT，即改变覆盖模式前后2年。评估“首次报告”和“最终报告”的夜间（22:00-07:00 h）和早晨（07:00-10:00 h）紧急成像TAT的中位数和第90百分位。采用分位数回归评估研究年份间TAT变化的统计学意义。对受训人员报告的数量及其轮岗评价进行了评估。结果：纳入128,433项急诊和住院影像研究（82,482例夜间和45,951例早晨）；40,136张ct， 83,993张x光片，2018张US和2286张mri。成像体积随着时间的推移而增加。除了第90百分位MRI首次报告TAT外，所有隔夜TAT指标在新的覆盖模型下均有统计学显著改善。例如，ED CT最终报告TAT中位数从8.45小时下降到1.38小时。上午成像显示，除了MRI TAT和第90百分位US Final report TAT外，所有TAT均有统计学意义上的降低。例如，ED CT最终报告TAT的中位数从1.56小时下降到1.19小时。学员报告的绝对成像体积在4年期间增加了14%，在实施后队列中，5分制加权平均轮换评估为3.9。结论：引入量身定制的内部夜间急诊放射科医生覆盖模型可以保护居民的自主权和生产力，同时在统计上显著减少夜间和次日早晨紧急成像的紧急成像报告周转时间。这可能有助于缓解急诊科的拥挤，同时保留实习生的教育经验。
Overnight emergency radiologist coverage model with preserved resident autonomy: impact on report turnaround times and resident experience.
Purpose: To evaluate the impact of overnight in-house emergency radiologist coverage on turnaround time (TAT) for emergent imaging of ED and inpatients, during the night and following morning, in a coverage model tailored to preserving resident autonomy.
Methods: Retrospective analysis of TAT for all emergent imaging of ED and inpatients at an academic Level-1 trauma center from September 2015 to August 2019, two years before and after changing coverage model. Median and 90th percentile were assessed for overnight (22:00-07:00 h.) and morning (07:00-10:00 h.) emergent imaging TAT for both the 'First report' and 'Final report'. Statistical significance of TAT changes between study years was assessed with quantile regression. Trainee report volumes and their rotation evaluations were assessed.
Results: 128,433 emergent ED and inpatient imaging studies (82,482 overnight and 45,951 morning) were included; 40,136 CTs, 83,993 X-rays, 2018 US and 2286 MRIs. Imaging volumes increased over time. Except 90th percentile MRI First report TAT, all overnight TAT metrics statistically significantly improved with the new coverage model. For example, ED CT median Final report TAT decreased from 8.45 h to 1.38 h. Morning imaging showed statistically significant reduction for all TATs, except for MRI TATs and 90th percentile US Final report TAT. For example, ED CT median Final report TAT decreased from 1.56 h to 1.19 h. Absolute imaging volume reported by trainees increased by 14% in the 4-year period and weighted average rotation evaluation on a 5-point scale was 3.9 in the post-implementation cohort.
Conclusion: Introduction of a tailored in-house overnight emergency radiologist coverage model can preserve resident autonomy and productivity while achieving statistically significant reduction of emergent imaging report turnaround time for emergent imaging overnight and the following morning. It may help mitigate ED overcrowding while preserving trainee educational experience.
期刊介绍：
To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!
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