After-Hours Radiology Coverage of ERs Varies Between Facilities

July 4, 2014

Whether an ED has access to radiology services and what those services entail varies greatly between facilities.

Academic radiology departments vary widely in how they cover after-hours emergency department examinations, according to an article published in the Journal of the American College of Radiology.

Researchers from the University of Virginia in Charlottesville undertook a study of neuroradiology fellowship programs in order to assess how radiology departments were covered after hours.

They contacted 96 institutional programs. A total of 67 participated in the online survey. The largest department had 169 attending radiologists, the smallest had 17 – the average was 53. The researchers asked about staffing composition and staffing methods, hours of available staff, and metrics used to measure before and after expansion of hours, if hours were expanded.[[{"type":"media","view_mode":"media_crop","fid":"25633","attributes":{"alt":"emergency radiology","class":"media-image media-image-right","id":"media_crop_6338664588984","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2373","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"line-height: 1.538em; height: 134px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

The results showed:

• 73 percent (49 of 67 programs) reported providing exclusively preliminary interpretations on emergency department reports for some overnight hours

• 27 percent of respondents (18 of 67) reported providing 24-hour real-time staff coverage

• Among those with around-the-clock staff coverage, 72 percent (13 of 18) have dedicated emergency department sections

• Two respondents offered 24-hour subspecialty staff coverage

• 48 percent (32) primarily use a form of the traditional on-call system and final interpretations are read in the morning

• 21 percent (15) used dedicated emergency department sections to cover some or all after-hours studies

• 19 percent (13) use rotating staff schedules

• 12 percent (8) use out-of-house services

Slightly more than half (52 percent) of the programs provided incentives for after-hour coverage, which included monetary compensation or time off. Both the amount of money offered and time offered varied considerably between facilities.

Expansion of hours occurred within the previous three years among 50 percent of respondents and half of those who have not expanded hours are considering doing so.

“Of the 33 departments that have recently expanded after-hours coverage, 28 programs (86 percent) felt that they were successful in resolving the key issue or issues that led to the change, while five (15 percent) felt unsuccessful,” the authors wrote.