Outside CT imaging among emergency department transfer patients

Area of Science:

• Radiology
• Healthcare Management
• Medical Imaging

Background:

• Emergency department (ED) transfers to tertiary care centers often involve outside computed tomographic (CT) examinations.
• The review and potential reinterpretation of these outside CT studies impact resource allocation and clinical workflow.

Purpose of the Study:

• To quantify the volume and types of outside CT scans submitted for reinterpretation in ED transfers.
• To determine the frequency and reasons for repeat CT imaging in this patient population.

Main Methods:

• A prospective audit of outside CT studies accompanying ED transfer patients over a 4-month period.
• Clinicians completed standardized forms detailing CT study type, report availability, discrepancies, and reasons for repeat imaging.

Main Results:

• 425 CT studies from 255 transfer patients were reviewed; 16% lacked outside reports.
• Interpretational discrepancies were found in 12% of studies with reports.
• Up to 25% of repeat scans (35% of repeat examinations) were potentially avoidable due to imaging or IT issues, particularly in trauma patients (32%).

Conclusions:

• Outside CT imaging contributes to workload and resource demands at receiving institutions.
• Communication gaps and interpretational discrepancies between transferring and receiving facilities are prevalent.
• Process improvements are needed to reduce avoidable repeat imaging.