P085: A low-cost solution to high-risk problem: enhancing communication of emergency physician x-ray interpretations to reading radiologist

Abstract

Introduction: There was a recognized lack of available system for Emergency Physicians (EPs) to communicate their x-ray interpretations to the reading Radiologist; this resulted in unnecessary flagging of cases with significant findings already seen by the EP or the possibility of incorrectly assuming a finding was seen by the EP. Our aim was to develop an IT-based system that permitted Radiologists to view EPs documented x-ray interpretations real-time. Based on engagement with both groups, it was essential that the system be user friendly and not add significantly to an already busy workload. Methods: An online reporting system was introduced in 2011, but with complaints that interpretations were not readily accessible, nor automatic. A revised system was launched in 2014 with 2 improvements: i) EP entered interpretation onto “sticky note” in PACs directly; and ii) EP interpretation “popped up” when a film was opened by Radiologist. Results: Both systems allowed data collection of the percentage of events EPs entered an interpretation. Prior to 2011, 0% of films had EP interpretations available to Radiologist, 33% with initial, and 53% with PACS. The revised system has enabled EPs to enter their x-ray interpretation which has resulted in improvement both subjectively, based on regular feedback from both EPs and Radiologists, and objectively. Conclusion: From this and other quality improvement initiatives, we have learned the importance of engaging frontline practitioners in process changes, specifically the impact on workflow. Also, utilizing existing IT systems and resources can result in positive change with minimal costs.