Overnight neuroradiologist coverage reduces turnaround times, increases physician satisfaction

Overnight attending radiologist coverage leads to reduced turnaround times, higher satisfaction among referring clinicians and increased educational value for residents, according to new research published in Current Problems in Diagnostic Radiology.

“Referring physicians have noted added value of high-quality attending level interpretation of radiology reports, and have occasionally advocated for final radiology reports overnight,” wrote Arvind Vijayasarathi, MD, MBA, of the University of California, Los Angeles, and colleagues. “In response, the trend towards on-site overnight attending radiologist coverage at academic medical centers has accelerated in recent years, increasing the prevalence four-fold since 2015.”

The researchers sought to determine the impact of 24/7/365 attending neuroradiology coverage on radiology resident perceptions of the on-call experience, referring physician satisfaction and final report turnaround times.

Coverage of the 24/7/365 attending neuroradiologist occured from October 2016 to March 2017. Vijayasarathi and colleagues sent a Likert-scale online survey to radiology residents and referring physicians in emergency medicine, neurosurgery and stroke neurology.

In the survey, referring physicians were asked about their perceptions of patient care, accuracy of the radiology report, turnaround time and the availability of attending radiologists before and after overnight neuroradiology coverage. Residents were asked about their level of independence, workload and education while on call. The researchers measured the turnaround time throughout the 5-month study period using electronic medical records.

A total of 28 out of 64 referring physicians responded to the survey. Nineteen of 23 second- and third-year radiology residents, eight of 21 neurosurgery residents, 16 of 39 emergency medicine residents and four stroke neurology fellows also replied. The researchers found:

  • 95 percent of residents reported “adequate independence” while working.
  • 100 percent of residents felt they had enough faculty support while working.
  • 84 percent of residents reported their overnight attendings improved the educational value of their on-call experience.
  • The surveyed stroke neurology fellows and neurosurgery residents reported positive perceptions of turnaround times, report quality and the accessibility of the attending radiologist.
  • 84 percent of emergency physicians perceived improved accuracy of reports, 69 percent thought timeliness of reports improved and 77 percent thought attending radiologists were more reachable for consultations.

Additionally, emergency department turnaround times decreased from 5.2 to 1.3 hours. Inpatient turnaround decreased from 7.6 to 4.2 hours.

The researchers noted their findings are consistent with previous findings on turnaround times and referring physician satisfaction; however, true patient outcome-based data was scarce in their literature review and additional research is necessary.

“Further investigation, at our institution and others, will be needed to assess the impact on patient care and cost of 24/7/365 coverage, most notably the difference or lack thereof between emergency radiology trained, general radiology, or subspecialist trained radiologists and the role the resident plays in generating (or not generating) a preliminary report,” the authors wrote.