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Staggered Radiologist Work Shifts Shown to Improve Patient Care

By MedImaging International staff writers
Posted on 27 Sep 2010

Implementation of staggered radiologist work shifts can expedite the communication of urgent findings and improve patient care, according to a recent study.

Radiology practice in the United States is moving toward 24-hour/7-day coverage, in which it has maximized coverage for imaging such as magnetic resonance imaging (MRI) and computed tomography (CT) interpretation either by utilizing on-call radiologists with their groups or teleradiology services. However, in many institutions, there is incomplete coverage for interpretation of other imaging such as conventional X-rays, particularly for overnight and early morning hours.

The study, performed at Massachusetts General Hospital and Harvard Medical School, both in Boston, MA, USA, included 6,448 portable X-ray exams that were performed during an early morning radiologist shift. Urgent findings requiring immediate communication were identified in 308 studies. "The early morning shift of radiologists, on average, communicated these findings two hours earlier as compared to our control group," said Rathachai Kaewlai, M.D., lead author of the study. The average elapsed time from image acquisition to the communication of urgent results was 340 minutes in the study group and 457 minutes in the control group.

"Prompt communication of findings that suggest a need for immediate or urgent medical intervention among healthcare professionals is very important for accurate and timely case management, which can potentially affect patient outcome," said Dr. Kaewlai. "Our results support the concept that staggered radiologist work shifts have the potential to expedite the communication of urgent findings and improve patient care. Imaging departments need to periodically reassess their staff coverage with a view to providing timelier image interpretation, and communication of imaging results, particularly urgent or critical findings."

The study's findings were published in the September 2010 issue of the Journal of the American College of Radiology.

Related Links:
Massachusetts General Hospital
Harvard Medical School

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69 (45.7763671875): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (367.87986755371): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (401.97372436523): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (46.968460083008): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (90.122222900391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (41.961669921875): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (39.100646972656): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (78.916549682617): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

105 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

106 (82.969665527344): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294731313 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (71.048736572266): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294731313 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

109 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

110 (74.148178100586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294731313 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (741.95861816406): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294731313 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (689.02969360352): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (416.99409484863): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

115 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

116 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

117 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

118 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

119 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

120 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

121 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

122 (365.01884460449): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 25478.839874268): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (714.06364440918): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731313 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731313 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 10673.046112061): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (101.08947753906): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (452.99530029297): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (57.93571472168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (339.98489379883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (286.10229492188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (272.98927307129): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (46.014785766602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (671.8635559082): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (500.20217895508): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (318.05038452148): SELECT name FROM jos_deeppockets WHERE id=215

138 (56.028366088867): SELECT name FROM jos_deeppockets WHERE id=215

139 (846.86279296875): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (727.17666625977): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (121.8318939209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

142 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

143 (!!!!! 12001.991271973): TRUNCATE TABLE jos_trademed_module

144 (156.16416931152): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294731313 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (90.837478637695): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294731313 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (753.16429138184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

149 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

150 (!!!!! 2870.0828552246): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

152 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

153 (67.949295043945): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294731313 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294731313 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (51.021575927734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

155 (49.114227294922): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

156 (65.088272094727): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

158 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294731313 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294731313 AND published='1' LIMIT 1

159 (169.99244689941): select jos_twitters.link from jos_twitters where cat=10

160 (61.988830566406): select jos_facebook.link from jos_facebook where cat=10

161 (50.067901611328): select jos_google_plus.link from jos_google_plus where cat=10

162 (46.014785766602): select jos_linkedin.link from jos_linkedin where cat=10

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