Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow

Area of Science:

• Radiology
• Emergency Medicine
• Healthcare Management

Background:

• Emergency Department (ED) patient flow is critical for timely care.
• Optimizing radiology services can impact ED efficiency.
• Continuous coverage models are increasingly explored in healthcare.

Purpose of the Study:

• To assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on ED patient flow.
• To analyze changes in ED length of stay (ED-LOS) and physician to disposition time (EP-DISP).
• To evaluate these impacts in an urban, quaternary-care teaching hospital.

Main Methods:

• An interrupted time-series analysis with a comparison group was employed.
• Data from 2008-2018 included 949,029 ED visits and 739,796 diagnostic tests.
• Linear regression models analyzed the impact of 24/7/365 ETR, with subgroup analyses by patient characteristics.

Main Results:

• A significant decrease in EP-DISP time was observed for patients needing only radiographs (-29 min).
• Overnight stroke patients and high-acuity patients requiring imaging showed reduced EP-DISP times (-78 min and -33 min, respectively).
• Major trauma patients experienced an increase in EP-DISP time (+46 min), with similar patterns in ED-LOS.

Conclusions:

• 24/7/365 in-house ETR coverage improved ED flow for specific patient groups, including those needing radiographs and overnight stroke care.
• Major trauma patients required more time in the ED, likely due to complex, multidisciplinary management needs.
• The findings suggest targeted benefits of continuous radiology coverage on ED efficiency.