RSNA 2010 

Abstract Archives of the RSNA, 2010


SSK09-02

Times of Major Discrepancies Made by On-Call Residents: A Link to Circadian Rhythms

Scientific Formal (Paper) Presentations

Presented on December 1, 2010
Presented as part of SSK09: Informatics (Quality and Safety)

Participants

Cole Fredrick Paul Mendenhall MD, Presenter: Nothing to Disclose
Richard B. Ruchman MD, Abstract Co-Author: Nothing to Disclose
Joseph Jaeger, Abstract Co-Author: Nothing to Disclose

PURPOSE

Determination of the time of major interpretation discrepancies between residents and attendings is felt to be multifactoral. The objective of our study was to determine the rate of discrepancies as a function of time.

METHOD AND MATERIALS

At our institution preliminary readings are reported by on-call residents for emergency studies. All discrepancies from May 16th 2007 to October 22nd 2009 were collected and archived. The time of discrepancies with the potential to cause mortality or acute morbidity was collected and analyzed. Major examples of discrepancies include intraperitoneal free air, inflammation, extra-vascular blood, stones, ischemia and intravascular thrombus. This information was used to generate a discrepancy rate as a function of time.

RESULTS

There were a total of 150 major discrepancies out of 13744 studies collected over 890 days. The hourly discrepancy rate varied from 3.61e-3 within the 6am hour to 2.93e-1 within the 5am hour with a bimodal distribution; modes were at 9pm and 5am. The time between 11pm to 5am demonstrated an inverse relationship of time awake to discrepancy rate.

CONCLUSION

The bimodal distribution of discrepancies of 9pm and 5am appeared to correspond to circadian rhythms. A near direct linear relationship was found when time and discrepancy rate were plotted between the hours of 11pm to 5am. These results suggest discrepancy rates are multifactoral, with the major determinants being time awake and circadian influences.

CLINICAL RELEVANCE/APPLICATION

Manipulation of various elements felt to affect wakefulness and circadian rhythms may be effective in decreasing the error rate of on-call residents.

Cite This Abstract

Mendenhall, C, Ruchman, R, Jaeger, J, Times of Major Discrepancies Made by On-Call Residents: A Link to Circadian Rhythms.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008480.html