Is a radiographer led immediate reporting service for emergency department referrals a cost effective initiative?
Authors: Maryann Hardy, John Hutton, Beverly Snaith
Rationale, aims, objectives
Demand for both Emergency Department (ED) and radiology services continues to increase across the UK while simultaneously, healthcare organisations are being asked to evaluate the quality of care provided and constrain service costs. National guidance on radiograph reporting times recommends ED radiographs are reported on day of patient attendance but in practice, delays in reporting persist. This study considers whether a radiographer led immediate reporting service for ED referrals could provide a cost-effective service improvement solution.
A pragmatic multi-centre randomised controlled trial was undertaken. 1502 patients were recruited and randomly assigned to an immediate or delayed reporting arm and treated according to group assignment. Patient health gain was measured in terms of change in utilities derived from EQ-5D responses at baseline and 8 week follow-up. Resources used and the costs of an immediate reporting service were analysed at the patient level and compared to standard reporting practices.
1688 radiographic examinations were performed (1502 patients). 79 discordant radiographic interpretations were identified (n = 79/1688; 4.7%). Interpretive errors were significantly reduced within immediate reporting arm. No significant difference was noted in the relative improvement in patient perceived health status between the 2 arms of the study. The average cost saving per patient in the immediate reporting arm was £23.40.
Radiographer led immediate reporting of ED radiographs is a cost-effective service development and its universal introduction could make a significant contribution to the current drive to increase service productivity within current budget constraints.