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After-hours radiology coverage in children's hospitals: a multi-center survey
Michael R Aquino1, Hillel S Maresky2,3, Afsaneh Amirabadi4
1Section of Pediatric Overnight Imaging, Cleveland Clinic Imaging Institute, 9500 Euclid Ave., Cleveland, OH, 44195, USA. aquinom3@ccf.org.
Insights
Pediatric emergency and trauma radiology coverage varies across North American children's hospitals. Most provide timely interpretations of X-rays, ultrasounds, and CT scans, often using a mix of evening and overnight shifts.
Area of Science:
- Radiology
- Pediatric Imaging
- Emergency Medicine
Background:
- Pediatric emergency and trauma radiology services are increasingly common.
- Models for after-hours coverage differ significantly among North American hospitals.
Purpose of the Study:
- To outline the scope of after-hours radiology services in children's hospitals.
- To identify the methods used by radiology departments for after-hours coverage.
Main Methods:
- A survey was developed by the Society for Pediatric Radiology Emergency and Trauma Imaging Committee.
- The survey was electronically distributed to representatives of 79 hospitals in the Society of Chiefs of Radiology at Children's Hospitals (SCORCH).
Main Results:
- 56% of hospitals responded to the survey.
- After-hours interpretation of radiographs, ultrasounds, and CT scans was common.
- Coverage models included evening/overnight shifts (39%), rotating blocks (25%), and limited pager coverage (5%).
- Attending pediatric radiologists staffed most shifts (63%), but trainees interpreted studies independently in 43% of hospitals.
Conclusions:
- Pediatric radiology after-hours coverage models are diverse.
- Most hospitals offer contemporaneous interpretation of key imaging modalities.
- Evening and overnight shifts are common, with attending radiologists on most shifts, though trainees also interpret studies independently.
Background:
Although the provision of pediatric emergency and trauma radiology has become increasingly prevalent in North America over the last few years, many hospitals differ in their models of providing after-hours coverage.
Objective:
To describe the scope of after-hours radiology services provided in children's hospitals in North America, and the means by which different radiology departments deliver this coverage.
Materials And Methods:
The Society for Pediatric Radiology Emergency and Trauma Imaging Committee developed a survey that we electronically distributed to a single representative from each of the 79 hospitals represented in the Society of Chiefs of Radiology at Children's Hospitals (SCORCH).
Results:
Completed questionnaires were submitted between Aug. 2, 2017, and Sept. 29, 2017, by 44/79 (56%) SCORCH representatives. Contemporaneous after-hours interpretation of radiographs (81%), ultrasounds (81%), body CT (79%) and neurologic CT (75%) with preliminary or final reports was common. Coverage was accomplished most commonly by a combination of evening and overnight shifts 17/44 (39%). Eleven of 44 (25%) hospitals used a model in which radiologists rotate working blocks of overnight service followed by blocks off service. Only 2/44 (5%) hospitals exclusively provided pager coverage after hours. Attending pediatric radiologists were assigned to the majority of after-hours shifts 110/175 (63%), but radiology trainees provided interpretations independently for varying periods of time at 19/44 (43%) surveyed hospitals. Incentives to work after hours included the option to work remotely, as well as additional income, time off, and academic time.
Conclusion:
The model for delivering after-hours pediatric radiology coverage varies. Most hospitals, however, provide contemporaneous interpretations of radiographs, US, body CT and neurologic CT. Most institutions use evening shifts to extend coverage later, with many providing subsequent overnight coverage. Although most shifts are staffed by attending pediatric radiologists, radiology trainees commonly interpret studies independently for varying durations of time after hours.
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