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On-call or not on-call, what difference does it make in paediatric radiology?
Willemijn M Klein1, Amaka C Offiah2,3, Ola Kvist4,5
1Department of Medical Imaging, Radboudumc/Amalia Children's Hospital, Nijmegen, The Netherlands. Willemijn.klein@radboudumc.nl.
Objectives:
There is an ever-increasing demand for out-of-hours expert opinion in paediatric radiology, which cannot be delivered in all hospitals. This study was designed to ascertain whether paediatricians, paediatric surgeons and radiologists are satisfied with the current situation; and to investigate the extent to which diagnostic errors are made while on-call with either residents, general or paediatric radiologists reporting on paediatric examinations.
Methods:
Two surveys were compiled and dispatched. The first, is to paediatricians, paediatric surgeons and paediatric radiologists questioning their satisfaction with the current on-call paediatric radiology services in their hospitals. The second, is to paediatric radiologists inviting them to retrospectively score the accuracy of the reporting on consecutive paediatric radiology examinations performed during on-call hours in their hospitals.
Results:
The first survey revealed that 40/49 (82%) paediatric physicians were satisfied with the paediatric radiology service during office hours, decreasing to 33% during on-call hours. In the second survey, a total of 464 on-call paediatric radiology examinations were analysed, demonstrating 20.2% misdiagnoses. General radiologists had more misdiagnoses and were slower in providing a report than residents.
Conclusion:
The current service with a lack of on-call paediatric radiologists, is associated with increased misdiagnoses and dissatisfaction among physicians and requires improvement.
Critical Relevance Statement:
This study shows that it may be a struggle to organise the 24-h availability of an expert paediatric radiologist, yet this might avoid 20% of misdiagnoses, half of which have direct clinical consequences.
Key Points:
The current organisation of paediatric radiology on-call rotas is unsatisfactory for many clinicians. A substantial amount of on-call paediatric radiology reports contain misdiagnoses, and these may have significant clinical consequences. Hospitals should reconfigure out-of-hours paediatric radiology covers.
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