title: Are all after-hours diagnostic imaging appropriate? An Australian Emergency Department pilot study.
abstract: BACKGROUND
  This study was aimed at determining the extent to which after-hours diagnostic imaging is appropriate within the case hospital's Emergency Department. This was amid growing concerns of the inappropriateness of some medical investigations within the Australian health-care system.
  
  
  METHODS
  After-hours referral data and patient notes were used in reviewing the clinical case. Diagnostic imaging was deemed appropriate if reflective of clinical guidelines, and if not reflective, whether the investigation changed the patient's ongoing management.
  
  
  RESULTS
  Results indicated that 96.37% of after-hours diagnostic imaging adhered to clinical guidelines and was appropriately requested, with 95.85% changing the ongoing management of the patient. The most sought after diagnostic imaging procedures were Chest X-Ray (30.83%), and CT Brain (16.58%), with 99.16% and 98.44 appropriateness respectively. Chest pain (14.49%) and motor vehicle accidents (8.12%) were the leading reason for ordering after-hours imaging.
  
  
  CONCLUSIONS
  This study provided an Emergency Department example as it relates to after-hours diagnostic imaging appropriateness. This study found that most after-hours referrals were appropriate.
authors.affiliation: Calvary Health Care Australia, Calvary Hospital Canberra, Cnr Belconnen Way & Haydon Drive, Bruce, ACT, 2617, Australia.
authors.forename: Fergus William
authors.initials: FW
authors.lastname: Gardiner
authors.affiliation: Calvary Health Care Australia, Calvary Hospital Canberra, Cnr Belconnen Way & Haydon Drive, Bruce, ACT, 2617, Australia.
authors.forename: Shaun
authors.initials: S
authors.lastname: Zhai
keywords: Emergency after-hours diagnostic imaging; Investigation appropriateness; Medical imaging; Medical testing