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Assessment of a reporting radiographer-led discharge system for minor injuries: a prospective audit over 2 years
  1. Deborah Henderson1,
  2. William K Gray1,
  3. Lisa Booth2
  1. 1North Tyneside General Hospital, North Shields, Tyne and Wear, UK
  2. 2University of Cumbria, Lancaster, UK
  1. Correspondence to Deborah Henderson, Radiological Department, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, UK; deborah.henderson{at}nhct.nhs.uk

Abstract

Background and purpose In the UK, there is a continuing effort within the National Health Service to reduce patient waiting times in emergency departments (EDs). This audit aimed to evaluate whether a reporting radiographer-led discharge system could reduce waiting times from x-ray to discharge with no detrimental effect on patient outcomes.

Methods A prospective audit over 2 years was conducted. Patients were considered for discharge by a reporting radiographer-led service if they were >5 years old, attended the hospital ED between 9:00 and 17:00, Monday to Friday, had an injury below the elbow in the upper limb or below the knee in the lower limb that required an x-ray, and were able to be discharged home without further medical intervention. Outcomes of interest were overall waiting times, accuracy of diagnosis and re-attendance at the ED within 28 days.

Results Between July 2006 and June 2008, 497 patients met the inclusion criteria and were discharged home by the radiographer-led service, and 2632 were discharged home using standard practices. Overall waiting times were >20 min quicker for the radiographer-led service at 100.9 min. The false negative rate was reduced from 2.09% to 0.2%, and re-attendance at the ED within 28 days for the same injury was reduced from 3.27% to only 0.4% for radiographer-led discharge.

Conclusions The service reduced waiting times and re-attendance rates while improving the accuracy of diagnosis. The efficacy of such services should be further studied in relation to more complex patient groups.

  • Radiography
  • discharge
  • radiographer
  • role development
  • acute medicine
  • accident prevention
  • accidental falls
  • burns
  • x-ray
  • cardiac care
  • diagnosis
  • communications
  • CT/MRI
  • diagnosis
  • forensic/legal medicine

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Footnotes

  • Competing interests None.

  • Ethics approval This was an audit of an existing service. The requirements of the Trust's Caldicott Guardian were met.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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