title: Assessment of a reporting radiographer-led discharge system for minor injuries: a prospective audit over 2 years.
abstract: OBJECTIVE
  In the UK, there is a continuing effort within the National Health Service to reduce patient waiting times in emergency departments (EDs). This audit aimed to evaluate whether a reporting radiographer-led discharge system could reduce waiting times from x-ray to discharge with no detrimental effect on patient outcomes.
  
  
  METHODS
  A prospective audit over 2 years was conducted. Patients were considered for discharge by a reporting radiographer-led service if they were >5 years old, attended the hospital ED between 9:00 and 17:00, Monday to Friday, had an injury below the elbow in the upper limb or below the knee in the lower limb that required an x-ray, and were able to be discharged home without further medical intervention. Outcomes of interest were overall waiting times, accuracy of diagnosis and re-attendance at the ED within 28 days.
  
  
  RESULTS
  Between July 2006 and June 2008, 497 patients met the inclusion criteria and were discharged home by the radiographer-led service, and 2632 were discharged home using standard practices. Overall waiting times were >20 min quicker for the radiographer-led service at 100.9 min. The false negative rate was reduced from 2.09% to 0.2%, and re-attendance at the ED within 28 days for the same injury was reduced from 3.27% to only 0.4% for radiographer-led discharge.
  
  
  CONCLUSIONS
  The service reduced waiting times and re-attendance rates while improving the accuracy of diagnosis. The efficacy of such services should be further studied in relation to more complex patient groups.
authors.affiliation: Radiological Department, North Tyneside General Hospital, Tyne and Wear, UK. deborah.henderson@nhct.nhs.uk
authors.forename: Deborah
authors.initials: D
authors.lastname: Henderson
authors.forename: William K
authors.initials: WK
authors.lastname: Gray
authors.forename: Lisa
authors.initials: L
authors.lastname: Booth
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D054869:Clinical Audit; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011859:Radiography; D006113:United Kingdom; D014850:Waiting Lists; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*; D055815:Young Adult