The impact of extended radiology attending coverage in a children's hospital

In order to achieve more "timely" interpretation of radiologic examinations, a 3 to 11 p.m. attending radiologist slot was incorporated into the daily schedule utilizing existing staff. Our purpose was to assess the effectiveness of this practice by measuring report generation times.

Using a radiology information system (DecRAD), the time between completion of the technical examination and dictation of the official report for general (plain film) studies was determined for a 2-month period and compared to similar periods 1 and 2 years prior to instituting extended hours. Emergency and portable (ICU) exams were similarly analyzed.

The number of examinations reported within 2 h of technical completion increased by 8.5% (mean); reporting within 4 h increased by 20%; reporting within 6 and 12 h of completion each increased by 24%. Over 80% of cases were dictated within 12 h after the change in practice occurred; whereas, it took up to 24 h in preceding years. Analysis of emergency and portable ICU exams showed similar trends, and the number of next day "call-backs" to the emergency department was significantly reduced.

By extending attending coverage, more plain film examinations, especially emergency cases and ICU portables, were read and reported within a shorter time providing prompt communication with clinicians and more opportunity to influence management decisions.