title: Reduction of "callbacks" to the ED due to discrepancies in plain radiograph interpretation.
abstract: Retrospective and prospective chart review was conducted to study patient callbacks to the emergency department (ED) based on plain radiograph interpretation discrepancies between radiologists and emergency physicians before and after a continuous quality improvement (CQI) intervention. Patients who were called back to the ED because of radiograph interpretation discrepancies were retrospectively studied. These results were reviewed by a CQI team, which recommended greater communication and consultation. A prospective study was then performed. Before quality intervention, 0.7% of the patients were recalled; 0.4% required recall after quality assurance, a reduction of 42.9% (P = .0001). Emergency physicians in this study had a low percentage of patient recall due to discrepancies in radiologic interpretation. CQI further reduced this percentage. The proficiency of emergency physicians interpreting radiographs validates the current practice of emergency physicians rendering treatment based on their interpretations and supports the notion of emergency physicians billing for this service.
authors.affiliation: Section of Emergency Medicine, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Preston
authors.forename: J J
authors.initials: JJ
authors.lastname: Marr
authors.forename: K K
authors.initials: KK
authors.lastname: Amaraneni
authors.forename: B S
authors.initials: BS
authors.lastname: Suthar
mesh_terms: D001071:Appointments and Schedules; D003142:Communication; D004635:Emergency Medicine; D004636:Emergency Service, Hospital; D005121:Extremities / Q000000981:diagnostic imaging; D005251:Fees, Medical; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D017408:Guidelines as Topic; D006801:Humans; D007400:Interprofessional Relations; D005791:Patient Care; D011014:Pneumonia / Q000000981:diagnostic imaging; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D011859:Radiography; D013902:Radiography, Thoracic; D011871:Radiology; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013131:Spine / Q000000981:diagnostic imaging; D013896:Thoracic Diseases / Q000000981:diagnostic imaging; D017749:Total Quality Management