X-ray reporting in accident and emergency departments--reducing errors

It is well recognized by accident and emergency clinicians and the defence societies that radiological abnormalities are frequently missed by the clinician who first looks at the X-rays. These errors may be compounded if the X-rays are not reported by a radiologist. The X-rays may be reported but the report is not seen by the clinician. The report may be seen by the clinician, but a system for recalling the patient is not put into operation. The purpose of this article is to make the important point that false positive and false negative misses on X-rays need to be communicated to the accident and emergency department promptly so that appropriate action can be taken. We describe an efficient method of communication.