A retrospective review of registrar out-of-hours reporting in a university hospital: the effect of time and seniority on discrepancy rates. Issue 6 (June 2018)

• Record Type: Journal Article
• Authors: Lam, V.; Stephenson, J.A.
• Is Part Of: Clinical radiology. Volume 73:Issue 6(2018)
• Page Start: 590.e9
• Page End: 590.e12
• Publication Date: 2018-06
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2018.01.012
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : Aim: To assess the influence of time, intensity, and trainee seniority on radiology registrars' major and minor discrepancy rates during weekend reporting at a university teaching hospital. Materials and methods: A 12-month retrospective review was performed of out-of-hours trainee provisional reports for computed tomography (CT) and magnetic resonance imaging (MRI) in a university teaching hospital. From Friday 9.00 pm to Sunday 9.00 pm, the out-of-hours service is provided by a single registrar rotating every 12 hours. A busy shift was defined as more than 24 reports issued during the shift. A senior trainee was defined as having more than 2 years' experience on the on-call rota. Reports were compared to subsequent subspecialist consultant review with all discrepancies collected. Discrepancy rates were calculated for junior/senior registrars, time of shift, and for busy/less busy shifts. Results: The total discrepancy rate was 11.1%, with a major discrepancy rate of 3%. Junior registrars had a lower total discrepancy rate (9.7% versus 12.2%, p =0.0065). Although there was no difference between major discrepancies, junior trainees made fewer minor discrepancies (7.1% versus 8.93%, p =0.03). The discrepancy rate was higher at night (12.3% versus 10.4%, p =0.0418). On a less busy shift, more discrepancies were made (12.8% versus 10%, p =0.0001). Conclusion: The major discrepancy rate of trainees is low. More discrepancies are made at night, and trainee seniority does not mitigate this problem. Night shifts are less busy in comparison to day shifts, which may explain why less busy shifts appear to yield more mistakes. Highlights: This study demonstrates that radiology registrars are capable of performing at high levels of accuracy throughout a shift. Accuracy deteriorates at night and interestingly, on less busy shifts. Junior registrars performed fewer night shifts, which may explain why they appear to make fewer mistakes.