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The costs and effects of introducing selectively trained radiographers to an A&E reporting service: a retrospective controlled before and after study

Brealey, S., King, D.G., Hahn, S., Godfrey, C., Crowe, M.T.I., Bloor, K., Crane, S. and Longsworth, D. (2005) The costs and effects of introducing selectively trained radiographers to an A&E reporting service: a retrospective controlled before and after study. The British Journal of Radiology, 78 (930). pp. 499-505. ISSN 0007-1285

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Abstract

The costs and effects of introducing selectively trained radiographers reporting accident and emergency (A&E) radiographs of the appendicular skeleton in a district general hospital were assessed using a retrospective controlled before and after design. Reference standard reports were compared with a random stratified sample of 200 A&E and 200 general practitioner (GP) reports before and after the intervention. GP reports were used as a non-intervention, non-equivalent control group. An A&E specialist registrar judged whether incorrect A&E reports might have a clinically important effect on patient management. The effect of incorrect A&E reports on outcome was assessed by patient re-attendance to the hospital because of missed abnormalities. The annual, average and incremental costs of radiographers and radiologists reporting A&E radiographs were calculated and a sensitivity analysis was undertaken. The introduction of the radiographers resulted in a 1% (95% CI –7.9 to 5.9) fall in A&E radiograph reporting accuracy and 11% (95% CI –33.7 to 11.3) reduction of cases in which incorrect A&E reports might have a clinically important effect on patient management. Only two A&E reports (one before and one after the intervention) affected patient outcome in that a fracture missed at the first visit resulted in patient re-attendance to the X-ray Department. There was a saving of £361 per annum to the X-ray Department. In conclusion this study provides further evidence that selectively trained radiographers can accurately report A&E plain radiographs and at no additional cost.

Item Type: Article
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 11 Feb 2009 12:57
Last Modified: 11 Feb 2009 12:57
Published Version: http://dx.doi.org/1259/bjr/51196310
Status: Published
Publisher: Brit Institute of Radiology
Identification Number: 10.1259/bjr/51196310
URI: http://eprints.whiterose.ac.uk/id/eprint/7764

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