title: Quality assessment of out sourced after-hours computed tomography teleradiology reports in a Central London University Hospital.
abstract: The study was designed to assess the quality of out sourced after-hours computed tomography teleradiology service reports. We evaluated 1028 patients over a time period of five month in 2009/2010 (437 female, 591 male, mean age: 51 years, range: 0-97 years) who were referred either by the A&E or other in house departments from 7 pm to 8 am for different reasons. Reporting was done by a teleradiology service provider located in the UK and Australia. Reports were assessed during the routinely performed morning meeting by a panel of in house radiologists. Assessment was done by a five point agreement scale (5="No disagreement", 1="…unequivocal potential for serious morbidity or threat to life"). In 811 (79%) patients no disagreement was found, 164 (16%) were rated as category 4, 40 (4%) as category 3 ("…likelihood of harm is low"). In 13 (1.3%) patients a decision of category 2 was made ("…strong likelihood of moderate morbidity but not threat to life"). No category 1 decision was made. As this was just a discrepancy decision, a follow up of the category 2 patients was done over a period of a maximum of 6 months. In 8 (0.8%) patients the in house reports were correct, in 2 (0.2%) patients the teleradiology service provider was right and in 3 (0.3%) patients the final diagnoses remained unclear. In conclusion there was a small rate (0.8%) of proven serious misinterpretations by the teleradiology service provider, but these were less than in comparable studies with preliminary in house staff reports (1.6-24.6%).
authors.affiliation: Imaging Department, University College Hospital, University College London Hospitals, University College London, 235 Euston Road, London NW1 2BU, UK. jhohmann@uhbs.ch
authors.forename: Joachim
authors.initials: J
authors.lastname: Hohmann
authors.forename: Petrie
authors.initials: P
authors.lastname: de Villiers
authors.forename: Carlo
authors.initials: C
authors.lastname: Urigo
authors.forename: Dino
authors.initials: D
authors.lastname: Sarpi
authors.forename: Caroline
authors.initials: C
authors.lastname: Newerla
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Brookes
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020416:Outsourced Services / Q000592:standards* / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019112:Teleradiology / Q000592:standards* / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data*; D055815:Young Adult