Effect of shift, schedule, and volume on interpretive accuracy

A retrospective analysis of 2.9 million radiologic examinations

Tarek N. Hanna, Christine Lamoureux, Elizabeth A Krupinski, Scott Weber, Jamlik Omari Johnson

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To determine whether there is an association between radiologist shift length, schedule, or examination volume and interpretive accuracy. Materials and Methods: This study was institutional review board approved and HIPAA compliant. A retrospective analysis of all major discrepancies from a 2015 quality assurance database of a teleradiology practice was performed. Board-certified radiologists provided initial preliminary interpretations. Discrepancies were identified during a secondary review by a practicing radiologist or through an internal quality assurance process and were vetted through a consensus radiology quality assurance committee. Unique anonymous radiologist identifiers were used to link the discrepancies to radiologists' shifts and schedules. Data were analyzed by using analysis of variance, t test, or x2 test. Results: A total of 4294 major discrepancies resulted from 2 922 377 examinations (0.15%). There was a significant difference for shift length (P < .0001) and volume (P < .0001) for shifts with versus those without discrepancies. On average, errors occurred a mean (± standard deviation) of 8.97 hours ± 2.28 into the shift (median, 10 hours; interquartile range, 2.0 hours). Significantly more errors occurred late in shifts than early (P < .0001), peaking between 10 and 12 hours. The number of major discrepancies in a single shift ranged from one to four, with a significant difference in the number of discrepancies as a function of study volume (volume for all shifts, 67.60 ± 60.24; volume for shifts with major discrepancies, 118.96 ± 66.89; P < .001). Despite a trend for more discrepancies after more consecutive days worked, the difference was not significant (P = .0893). Conclusion: Longer shifts and higher diagnostic examination volumes are associated with increased major interpretive discrepancies. These are more likely to occur later in a shift, peaking after the 10th hour of work.

Original languageEnglish (US)
Pages (from-to)205-212
Number of pages8
JournalRadiology
Volume287
Issue number1
DOIs
StatePublished - Apr 1 2018
Externally publishedYes

Fingerprint

Appointments and Schedules
Teleradiology
Health Insurance Portability and Accountability Act
Research Ethics Committees
Radiology
Analysis of Variance
Radiologists
Databases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Effect of shift, schedule, and volume on interpretive accuracy : A retrospective analysis of 2.9 million radiologic examinations. / Hanna, Tarek N.; Lamoureux, Christine; Krupinski, Elizabeth A; Weber, Scott; Johnson, Jamlik Omari.

In: Radiology, Vol. 287, No. 1, 01.04.2018, p. 205-212.

Research output: Contribution to journalArticle

Hanna, Tarek N. ; Lamoureux, Christine ; Krupinski, Elizabeth A ; Weber, Scott ; Johnson, Jamlik Omari. / Effect of shift, schedule, and volume on interpretive accuracy : A retrospective analysis of 2.9 million radiologic examinations. In: Radiology. 2018 ; Vol. 287, No. 1. pp. 205-212.
@article{9235dc42fcf64214b4225e0ee7ff7924,
title = "Effect of shift, schedule, and volume on interpretive accuracy: A retrospective analysis of 2.9 million radiologic examinations",
abstract = "Purpose: To determine whether there is an association between radiologist shift length, schedule, or examination volume and interpretive accuracy. Materials and Methods: This study was institutional review board approved and HIPAA compliant. A retrospective analysis of all major discrepancies from a 2015 quality assurance database of a teleradiology practice was performed. Board-certified radiologists provided initial preliminary interpretations. Discrepancies were identified during a secondary review by a practicing radiologist or through an internal quality assurance process and were vetted through a consensus radiology quality assurance committee. Unique anonymous radiologist identifiers were used to link the discrepancies to radiologists' shifts and schedules. Data were analyzed by using analysis of variance, t test, or x2 test. Results: A total of 4294 major discrepancies resulted from 2 922 377 examinations (0.15{\%}). There was a significant difference for shift length (P < .0001) and volume (P < .0001) for shifts with versus those without discrepancies. On average, errors occurred a mean (± standard deviation) of 8.97 hours ± 2.28 into the shift (median, 10 hours; interquartile range, 2.0 hours). Significantly more errors occurred late in shifts than early (P < .0001), peaking between 10 and 12 hours. The number of major discrepancies in a single shift ranged from one to four, with a significant difference in the number of discrepancies as a function of study volume (volume for all shifts, 67.60 ± 60.24; volume for shifts with major discrepancies, 118.96 ± 66.89; P < .001). Despite a trend for more discrepancies after more consecutive days worked, the difference was not significant (P = .0893). Conclusion: Longer shifts and higher diagnostic examination volumes are associated with increased major interpretive discrepancies. These are more likely to occur later in a shift, peaking after the 10th hour of work.",
author = "Hanna, {Tarek N.} and Christine Lamoureux and Krupinski, {Elizabeth A} and Scott Weber and Johnson, {Jamlik Omari}",
year = "2018",
month = "4",
day = "1",
doi = "10.1148/radiol.2017170555",
language = "English (US)",
volume = "287",
pages = "205--212",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",

}

TY - JOUR

T1 - Effect of shift, schedule, and volume on interpretive accuracy

T2 - A retrospective analysis of 2.9 million radiologic examinations

AU - Hanna, Tarek N.

AU - Lamoureux, Christine

AU - Krupinski, Elizabeth A

AU - Weber, Scott

AU - Johnson, Jamlik Omari

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Purpose: To determine whether there is an association between radiologist shift length, schedule, or examination volume and interpretive accuracy. Materials and Methods: This study was institutional review board approved and HIPAA compliant. A retrospective analysis of all major discrepancies from a 2015 quality assurance database of a teleradiology practice was performed. Board-certified radiologists provided initial preliminary interpretations. Discrepancies were identified during a secondary review by a practicing radiologist or through an internal quality assurance process and were vetted through a consensus radiology quality assurance committee. Unique anonymous radiologist identifiers were used to link the discrepancies to radiologists' shifts and schedules. Data were analyzed by using analysis of variance, t test, or x2 test. Results: A total of 4294 major discrepancies resulted from 2 922 377 examinations (0.15%). There was a significant difference for shift length (P < .0001) and volume (P < .0001) for shifts with versus those without discrepancies. On average, errors occurred a mean (± standard deviation) of 8.97 hours ± 2.28 into the shift (median, 10 hours; interquartile range, 2.0 hours). Significantly more errors occurred late in shifts than early (P < .0001), peaking between 10 and 12 hours. The number of major discrepancies in a single shift ranged from one to four, with a significant difference in the number of discrepancies as a function of study volume (volume for all shifts, 67.60 ± 60.24; volume for shifts with major discrepancies, 118.96 ± 66.89; P < .001). Despite a trend for more discrepancies after more consecutive days worked, the difference was not significant (P = .0893). Conclusion: Longer shifts and higher diagnostic examination volumes are associated with increased major interpretive discrepancies. These are more likely to occur later in a shift, peaking after the 10th hour of work.

AB - Purpose: To determine whether there is an association between radiologist shift length, schedule, or examination volume and interpretive accuracy. Materials and Methods: This study was institutional review board approved and HIPAA compliant. A retrospective analysis of all major discrepancies from a 2015 quality assurance database of a teleradiology practice was performed. Board-certified radiologists provided initial preliminary interpretations. Discrepancies were identified during a secondary review by a practicing radiologist or through an internal quality assurance process and were vetted through a consensus radiology quality assurance committee. Unique anonymous radiologist identifiers were used to link the discrepancies to radiologists' shifts and schedules. Data were analyzed by using analysis of variance, t test, or x2 test. Results: A total of 4294 major discrepancies resulted from 2 922 377 examinations (0.15%). There was a significant difference for shift length (P < .0001) and volume (P < .0001) for shifts with versus those without discrepancies. On average, errors occurred a mean (± standard deviation) of 8.97 hours ± 2.28 into the shift (median, 10 hours; interquartile range, 2.0 hours). Significantly more errors occurred late in shifts than early (P < .0001), peaking between 10 and 12 hours. The number of major discrepancies in a single shift ranged from one to four, with a significant difference in the number of discrepancies as a function of study volume (volume for all shifts, 67.60 ± 60.24; volume for shifts with major discrepancies, 118.96 ± 66.89; P < .001). Despite a trend for more discrepancies after more consecutive days worked, the difference was not significant (P = .0893). Conclusion: Longer shifts and higher diagnostic examination volumes are associated with increased major interpretive discrepancies. These are more likely to occur later in a shift, peaking after the 10th hour of work.

UR - http://www.scopus.com/inward/record.url?scp=85044286490&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044286490&partnerID=8YFLogxK

U2 - 10.1148/radiol.2017170555

DO - 10.1148/radiol.2017170555

M3 - Article

VL - 287

SP - 205

EP - 212

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 1

ER -