Risk-benefit analysis of a multi-site radiographer comment model for emergency departments

Area of Science:

• Radiology
• Medical Imaging
• Patient Safety

Background:

• Critical X-ray findings require timely communication to emergency department (ED) physicians.
• Current communication methods may not always ensure appropriate time frames for critical findings.
• International practices of radiographer alerts exist, but risk data is limited.

Purpose of the Study:

• To assess the risk-benefit of a hybrid radiographer comment and alert model for communicating abnormal X-ray findings.
• To evaluate the safety and timeliness of information transfer to ED physicians.
• To provide risk assessment data for radiographer alerting practices.

Main Methods:

• A pilot study in New South Wales involved 69 radiographers providing 1102 comments to five EDs over 3-12 months.
• Site auditors classified comments as true positive, false positive, or indeterminate.
• False positive comments were risk-assessed by independent reviewers for adverse outcomes.

Main Results:

• Out of 1102 comments, 42 (3.9%) were false positives, with 37 assessed as low-risk and 5 as low-moderate risk.
• No high-risk cases were identified from false positive comments.
• 282 direct or potential patient benefits were identified, and 42 radiology report discrepancies were incidentally found.

Conclusions:

• The radiographer alert and comment system demonstrated low risk to patients in the pilot study.
• Direct communication by radiographers for abnormal findings can reduce diagnostic errors.
• This communication strategy has the potential to improve patient safety and health outcomes.