title: Audit of the change in the on-call practices in neuroradiology and factors affecting it.
abstract: BACKGROUND
  On call practices had recently changed at the Newcastle General Hospital to accommodate increasing CT scan requests and reduce the workloads of the radiologists. In the new system, the person responsible for dealing with the out of hours requests for imaging changed from the neuroradiologist to the neuroradiographer. This audit was conducted to assess any change in the departmental workload as a result of this change.
  
  
  METHODS
  The audit was carried out over a period of six months and data was collected from the on-call booklets which the neuroradiographers maintained and the log books maintained in the department of neuroradiology. Details of the imaging requested; the source of the request, the reason for the request and the results of the scans were recorded and analysed using Microsoft Excel.
  
  
  RESULTS
  The number of CT scans requested from the A&E went up by 73.4% after the change in practice and majority of these increases were due to increased requests for scans on head injuries which increased by 122%. Although this was not statistically significant due to lack of study power, it is clinically relevant.
  
  
  CONCLUSIONS
  The increase in the number of CT scans for head injuries reflects a general change in practice in management of head injuries in the UK. Changing the gatekeeper from radiologist to radiographer was associated with an increase in CT rate, particularly for head injuries. Other factors such as clinician seniority and a greater awareness of the NICE guidelines may have also contributed.
authors.affiliation: Department of Neurosurgery, Newcastle General Hospital, Newcastle-upon-Tyne, NE4 6BE, UK. mukerji@doctors.org.uk
authors.forename: Nitin
authors.initials: N
authors.lastname: Mukerji
authors.forename: Dorothy
authors.initials: D
authors.lastname: Wallace
authors.forename: Dipayan
authors.initials: D
authors.lastname: Mitra