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Radiology registrar on-call reporting accuracy
S20
Abstract / Clinical Radiology 69 (2014) S11eS22
Results of 1st audit round: CT- avg 27%, median 15%, range 0-90% CR- avg 11%, median 8%, range 2-38% 1 CR report made no sense. Targets not met. Types of errors - similar sounding words, lack of punctuations, words cut off, extra words. 1st action plan: 1. Presented at departmental and hospital audit meeting 2. Recommend RIS that would support auto-transcription of ’clinical details’ 3. Feedback to reporter 4. Repeat audit in 6 months Results of 2nd round: March - April 2014. CTe avg 23%; median 5%; range 0-100% CReavg18%; median 8%; range 2e84% Targets not met. Reporter A continues to have high VR error rate. Other reporters have good improvement. Overall improvement in CT errors. CR errors have deteriorated. Errors are mainly of voice recognition and punctuation. Majority of errors are mild and in clinical details. 2nd action plan:1. Present at departmental audit meeting 2. Urgent recommendation of RIS that would support auto-transcription of ‘clinical details’ 3. Feedback to reporter
Standard, indicator and target: 100% of patients with unexpected findings should either: Have their report faxed to the referring clinician or Be added to a relevant MDT meeting for discussion. Methodology: Data Set: All emails regarding unexpected findings that were sent to radiology secretaries during a one month period (November 2013) were retrieved from the radiology information system. These emails may request for the report to be urgently faxed to the referring clinician OR request that the patient is added to the relevant MDT meeting. Hospital records were then analysed to ensure these patients had been followed up as appropriate. Results of 1st audit round: Of the email requests for a report to be faxed, 94% (50/53) had records confirming that a fax had been sent. Average time lag ¼ 3 days Of the email requests for MDT discussion, 90% (43/48) of patient records confirmed they were discussed at MDT. Average time lag ¼ 7 days All remaining patients were accounted for and followed up. 1st action plan: 1. Standardise the format of email requests and of the electronic record showing the request was actioned 2. Departmental meeting to suggest a more robust and failsafe method of communicating urgent findings to clinicians
Radiology registrar on-call reporting accuracy
Patient satisfaction with day case provision of interventional radiology procedures
Authors: Victoria Chan*, Heiko Parvizi, James Briggs
Peschl, Matthew
Smedley, Nassim Authors: Jessie Gil*, James H. Briggs, Brenda Shanahan, Mark Bratby, Raman Uberoi
Background: At our Trust, on- call registrars (ST3+) issue verified reports, subsequently checked by consultants within 24 hours. Clinical teams should be contacted when there are discrepancies to allow for changes in management. Standard, indicator and target: An RCR AuditLive template proposed a 2-5% error rate for on-call reporting (2% for significant errors,5% for all discrepancies affecting management). Methodology: All on-call registrar reports were compared with consultant addendums for February 2013.Discrepancies were categorised according to grading system, 1 ¼ minor error with no significance,2 ¼ minor error affecting long-term outcome, 3 ¼ major error affecting long-term outcome,4 ¼ major error affecting immediate outcome. Results of 1st audit round: Total of 646 reports,77(11.9%) had corrections:22 scored 1(3.4%),25 scored 2(3.9%),22 scored 3(3.4%),8 scored 4(1.2%). 1st action plan: This audit demonstrates that issuing on-call reports by registrars is safe with only a small proportion of acutely significant discrepancies.It also emphasises the value of Consultant review, with subsequent amendments impacting upon management. Results of 2nd round: Follow-up audit for February 2014 had total of 770 reports,66(8.6%) had corrections:34 scored 1(4.4%),17 scored 2(2.2%),13 scored 3(1.7%),2 scored 4(0.3%). 2nd action plan: Again, the on-call registrar reporting accuracy was within ’general target’ despite increased workload in 2014.Nevertheless,we recommend regular monitoring of on-call workload and registrar reporting accuracy to ensure a high standard for patient care and safety.
Background: Day case intervention reduces patient stay, can improve patient experience and reduce overall procedural cost. Provision of good patient experience an important measure of care. Standard, indicator and target: Standards were locally agreed, based on NICE standards (1) . 90% of patients should have been pre-assessed and 90% should receive written information in advance. We wished for mean satisfaction score of 4 out of 5. Methodology: Patient perception was assessed using a 13 part survey comprising binary questions and scaled responses (1-very poor to 5excellent). Data were collected over eight weeks. Results of 1st audit round: 53 patients were surveyed. 93% had preadmission consultation. 86.7% had received written information. Mean scores to other questions all met the agreed standard. 1st action plan: Improved systems for administering information leaflets. Results of 2nd round: 52 Patients were surveyed. 76.9% were pre-assessed by telephone or in person, fewer than 50% of patients received written information and 3.8% had no pre-admission information. Standards for satisfaction with the consent process and addressing consent questions were again met. Patients were highly satisfied with the availability of staff to answer questions and their reassurance post-procedure. Overall patient satisfaction was ’very good’ or better. 2nd action plan: Overall satisfaction was increased and met targets, but improved administration to ensure higher rates of pre-assessment and written information provision is required.
Unexpected findings e the importance of safety nets
Non-contrast CT KUB in acute renal colic
Authors: Sean J. McIlhone*, Bhavin Narayanan, Catriona Davies
Rawal, Jeremy
Lynch, Priya
Background: Timely communication of reports and alerting clinicans to critical/unexpected findings is essential for patient safety and in preventing serious untoward incidents. Following the RCR’s updated guidance on this issue (1), we audited the existing ’safety net’ procedures in our imaging department.
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Guarantor Guarantor Guarantor Guarantor
and and and and
correspondent: correspondent: correspondent: correspondent:
Victoria Chan Sean J. McIlhone Jessie Gil Matthew Pickford
Authors: Matthew Pickford*, George Yeung Background: We perceived a low diagnostic yield for CT KUB when balanced against radiation exposure in our younger patients, particularly young women. We therefore audited our detection rates for stones and other significant pathology. Standard, indicator and target: The highest and lowest detection rates identified by literature review for stones and other significant pathology
Abstract / Clinical Radiology 69 (2014) S11eS22
Results of 1st audit round: CT- avg 27%, median 15%, range 0-90% CR- avg 11%, median 8%, range 2-38% 1 CR report made no sense. Targets not met. Types of errors - similar sounding words, lack of punctuations, words cut off, extra words. 1st action plan: 1. Presented at departmental and hospital audit meeting 2. Recommend RIS that would support auto-transcription of ’clinical details’ 3. Feedback to reporter 4. Repeat audit in 6 months Results of 2nd round: March - April 2014. CTe avg 23%; median 5%; range 0-100% CReavg18%; median 8%; range 2e84% Targets not met. Reporter A continues to have high VR error rate. Other reporters have good improvement. Overall improvement in CT errors. CR errors have deteriorated. Errors are mainly of voice recognition and punctuation. Majority of errors are mild and in clinical details. 2nd action plan:1. Present at departmental audit meeting 2. Urgent recommendation of RIS that would support auto-transcription of ‘clinical details’ 3. Feedback to reporter
Standard, indicator and target: 100% of patients with unexpected findings should either: Have their report faxed to the referring clinician or Be added to a relevant MDT meeting for discussion. Methodology: Data Set: All emails regarding unexpected findings that were sent to radiology secretaries during a one month period (November 2013) were retrieved from the radiology information system. These emails may request for the report to be urgently faxed to the referring clinician OR request that the patient is added to the relevant MDT meeting. Hospital records were then analysed to ensure these patients had been followed up as appropriate. Results of 1st audit round: Of the email requests for a report to be faxed, 94% (50/53) had records confirming that a fax had been sent. Average time lag ¼ 3 days Of the email requests for MDT discussion, 90% (43/48) of patient records confirmed they were discussed at MDT. Average time lag ¼ 7 days All remaining patients were accounted for and followed up. 1st action plan: 1. Standardise the format of email requests and of the electronic record showing the request was actioned 2. Departmental meeting to suggest a more robust and failsafe method of communicating urgent findings to clinicians
Radiology registrar on-call reporting accuracy
Patient satisfaction with day case provision of interventional radiology procedures
Authors: Victoria Chan*, Heiko Parvizi, James Briggs
Peschl, Matthew
Smedley, Nassim Authors: Jessie Gil*, James H. Briggs, Brenda Shanahan, Mark Bratby, Raman Uberoi
Background: At our Trust, on- call registrars (ST3+) issue verified reports, subsequently checked by consultants within 24 hours. Clinical teams should be contacted when there are discrepancies to allow for changes in management. Standard, indicator and target: An RCR AuditLive template proposed a 2-5% error rate for on-call reporting (2% for significant errors,5% for all discrepancies affecting management). Methodology: All on-call registrar reports were compared with consultant addendums for February 2013.Discrepancies were categorised according to grading system, 1 ¼ minor error with no significance,2 ¼ minor error affecting long-term outcome, 3 ¼ major error affecting long-term outcome,4 ¼ major error affecting immediate outcome. Results of 1st audit round: Total of 646 reports,77(11.9%) had corrections:22 scored 1(3.4%),25 scored 2(3.9%),22 scored 3(3.4%),8 scored 4(1.2%). 1st action plan: This audit demonstrates that issuing on-call reports by registrars is safe with only a small proportion of acutely significant discrepancies.It also emphasises the value of Consultant review, with subsequent amendments impacting upon management. Results of 2nd round: Follow-up audit for February 2014 had total of 770 reports,66(8.6%) had corrections:34 scored 1(4.4%),17 scored 2(2.2%),13 scored 3(1.7%),2 scored 4(0.3%). 2nd action plan: Again, the on-call registrar reporting accuracy was within ’general target’ despite increased workload in 2014.Nevertheless,we recommend regular monitoring of on-call workload and registrar reporting accuracy to ensure a high standard for patient care and safety.
Background: Day case intervention reduces patient stay, can improve patient experience and reduce overall procedural cost. Provision of good patient experience an important measure of care. Standard, indicator and target: Standards were locally agreed, based on NICE standards (1) . 90% of patients should have been pre-assessed and 90% should receive written information in advance. We wished for mean satisfaction score of 4 out of 5. Methodology: Patient perception was assessed using a 13 part survey comprising binary questions and scaled responses (1-very poor to 5excellent). Data were collected over eight weeks. Results of 1st audit round: 53 patients were surveyed. 93% had preadmission consultation. 86.7% had received written information. Mean scores to other questions all met the agreed standard. 1st action plan: Improved systems for administering information leaflets. Results of 2nd round: 52 Patients were surveyed. 76.9% were pre-assessed by telephone or in person, fewer than 50% of patients received written information and 3.8% had no pre-admission information. Standards for satisfaction with the consent process and addressing consent questions were again met. Patients were highly satisfied with the availability of staff to answer questions and their reassurance post-procedure. Overall patient satisfaction was ’very good’ or better. 2nd action plan: Overall satisfaction was increased and met targets, but improved administration to ensure higher rates of pre-assessment and written information provision is required.
Unexpected findings e the importance of safety nets
Non-contrast CT KUB in acute renal colic
Authors: Sean J. McIlhone*, Bhavin Narayanan, Catriona Davies
Rawal, Jeremy
Lynch, Priya
Background: Timely communication of reports and alerting clinicans to critical/unexpected findings is essential for patient safety and in preventing serious untoward incidents. Following the RCR’s updated guidance on this issue (1), we audited the existing ’safety net’ procedures in our imaging department.
* * * *
Guarantor Guarantor Guarantor Guarantor
and and and and
correspondent: correspondent: correspondent: correspondent:
Victoria Chan Sean J. McIlhone Jessie Gil Matthew Pickford
Authors: Matthew Pickford*, George Yeung Background: We perceived a low diagnostic yield for CT KUB when balanced against radiation exposure in our younger patients, particularly young women. We therefore audited our detection rates for stones and other significant pathology. Standard, indicator and target: The highest and lowest detection rates identified by literature review for stones and other significant pathology