Radiology practices in emergency departments associated with pediatric residency training programs

Area of Science:

• Pediatric Radiology
• Emergency Medicine
• Healthcare Quality Improvement

Background:

• Academic emergency departments (EDs) are crucial for pediatric resident training.
• Assessing radiology practices in these settings is vital for patient care.
• Current practices may not consistently involve immediate radiologist interpretation.

Purpose of the Study:

• To evaluate current radiology practices in academic EDs serving children.
• To identify variations in radiologist availability and interpretation protocols.
• To understand the extent of emergency physician interpretation of pediatric radiographs.

Main Methods:

• A postal survey was conducted among 116 directors of academic EDs serving pediatric residents.
• 103 ED directors (89% response rate) completed the survey.
• Data collected included hospital type, fellowship availability, and overnight radiology coverage.

Main Results:

• Only 8% of EDs had radiologists immediately read every study.
• 66% of EDs had radiology residents overnight, more common in non-children's hospitals.
• Emergency physicians interpreted pediatric radiographs overnight in 57% (attending) and 44% (house staff) of EDs, often without immediate radiologist backup.

Conclusions:

• Significant variability exists in pediatric radiology practices within academic EDs.
• Overnight interpretation of pediatric radiographs by emergency physicians is common, with limited radiologist oversight.
• There is a need to improve radiologist availability and formal review processes in pediatric EDs.