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Jason N Itri1, Regina O Redfern, Mary H Scanlon

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Implementing targeted missed case conferences significantly reduced radiology resident discrepancies in emergency department interpretations. This data-driven approach improved patient care by addressing specific error patterns in preliminary radiology reports.

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Area of Science:

  • Radiology
  • Medical Education
  • Quality Improvement

Background:

  • Radiology residents interpret emergency department (ED) studies during off-hours.
  • Discrepancies between resident and faculty interpretations can impact patient care.

Purpose of the Study:

  • To evaluate the effectiveness of missed case conferences in reducing resident interpretation discrepancies.
  • To determine if a software-based system can track and analyze these discrepancies.

Main Methods:

  • The Minerva software program was used to identify and grade discrepancies (minor/major) in resident preliminary reports.
  • Discrepancy rates were calculated to assess performance and inform interventions.
  • Topic-specific conferences were developed based on trend analysis of missed cases.

Main Results:

  • The overall resident discrepancy rate was 2.6% (SD 0.7%), with a major discrepancy rate of 1.1% (SD 0.4%).
  • Targeted conferences on specific injuries led to a 64% decrease in related missed cases.

Conclusions:

  • Systematic evaluation of resident discrepancies using software provides a metric for competency assessment.
  • Missed case conferences are an effective intervention to reduce resident errors and improve diagnostic accuracy.
  • This process is expected to further decrease discrepancy rates and missed cases in radiology resident interpretations.