On-call or not on-call, what difference does it make in paediatric radiology?

Area of Science:

• Medical Imaging
• Paediatric Radiology
• Healthcare Management

Background:

• Increasing demand for 24/7 paediatric radiology expertise.
• Current out-of-hours services are insufficient in many hospitals.
• Need to assess clinician satisfaction and diagnostic accuracy during on-call periods.

Purpose of the Study:

• Evaluate satisfaction levels of paediatricians, paediatric surgeons, and radiologists with current on-call paediatric radiology services.
• Determine the frequency of diagnostic errors in paediatric radiology examinations performed during on-call hours.
• Identify factors contributing to misdiagnoses, such as reporting by non-specialists or residents.

Main Methods:

• Two surveys were distributed to assess satisfaction with on-call paediatric radiology services.
• Paediatric radiologists retrospectively reviewed 464 on-call paediatric radiology examinations for accuracy.
• Data collected on reporting turnaround times and diagnostic error rates for different radiologist levels (residents, general, paediatric).

Main Results:

• 82% of paediatric physicians were satisfied with daytime services, dropping to 33% for on-call services.
• 20.2% of on-call paediatric radiology examinations contained misdiagnoses.
• General radiologists exhibited higher misdiagnosis rates and slower reporting times compared to residents.

Conclusions:

• The current on-call paediatric radiology system is inadequate, causing physician dissatisfaction and increased diagnostic errors.
• A lack of dedicated on-call paediatric radiologists contributes to a substantial rate of misdiagnoses with clinical consequences.
• Reconfiguration of out-of-hours paediatric radiology services is essential to improve accuracy and patient safety.