title: Audit of demand for after-hours CT scanning services in RANZCR-accredited training departments.
abstract: BACKGROUND
  The aims of this study were to measure: (i) the growth in after-hours emergency department--referred CT (ED-CT) performed in accredited training departments between 2011 and 2013; (ii) the growth in ED CT relative to growth in ED presentations at the same hospitals; and (iii) trainee workload resulting from after-hours ED CT.
  
  
  METHODS
  Ethics approval was obtained for all participating sites. Accredited training facilities in Australia and New Zealand with three or more trainees and serving one or more EDs were invited to participate (N = 32). Four nights were surveyed between August and December 2013. For data collection, the number of ED patients having one or more CT scans; ED CT scan total images; non-contrast head CTs; and ED patients (total and categories 1 and 2) attending the ED in the preceding 24 h and first half of calendar year were collected for 2013 and corresponding days in 2012 and 2011. Trainee staffing levels were measured.
  
  
  RESULTS
  Eleven of 32 sites provided data for all four nights and 14 of 32 for one or more nights. A 15.7% increase in number of ED CTs between 1700 and 2200 h and 16.8% increase between 2201 and 0730 h occurred in the 2 years between 2011 and 2013 compared with a 6.9% increase in overall ED and 26% increase in categories 1 and 2 presentations over the same period. The number of CT images, however, increased 23%.
  
  
  CONCLUSIONS
  Growth in demand by EDs for after-hours CT services has implications for service provision and trainee workloads in Royal Australian and New Zealand College of Radiologists-accredited training departments.
authors.affiliation: Monash Imaging, Monash Health, Clayton, Victoria, Australia.|Department of Surgery, Southern Clinical School, Monash University, Clayton, Victoria, Australia.
authors.forename: Stacy K
authors.initials: SK
authors.lastname: Goergen
authors.affiliation: The Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Grimm
authors.affiliation: Monash Centre for Health Research and Innovation, Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: Eldho
authors.initials: E
authors.lastname: Paul
authors.affiliation: Department of Radiology, Austin Health, Heidelberg, Victoria, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Fabiny
authors.affiliation: Department of Medical Imaging, St Vincent's Hospital, Melbourne, Australia.
authors.forename: Wai Kit
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Radiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Blome
authors.affiliation: Department of Radiology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Zhou
authors.affiliation: The Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Munro
mesh_terms: D000068:Accreditation / Q000592:standards*; D039602:After-Hours Care / Q000592:standards / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000592:standards / Q000706:statistics & numerical data*; D008485:Medical Audit; D009520:New Zealand / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000592:standards / Q000706:statistics & numerical data*; D014600:Utilization Review; D016526:Workload / Q000706:statistics & numerical data
keywords: CT scanning; emergency medicine; radiology; workforce