King Fahad Specialist Hospital, Buraidah, Qassim,
Kingdom of Saudi Arabia
Appropriate referrals for out of Hours CT imaging? An Audit to
establish any difference to patient management by introduction of
out sourcing
Abdul Rehman Tahir1, Alaa Khalifa2
1King
Fahad Specialist Hospital, Buraidah, Qassim, KSA
Introduction
King Fahad Specialist Hospital as a tertiary care hospital provide out of hours imaging service. The
steady increase in out of hours CT requests was noted since introduction of outsourcing that resulted in
financial and management difficulties. An audit was conducted against the standard of locally agreed
and RCR guidelines. All out-of-hours examinations should make a difference to patient management
before the next available routine examination (target of 100%).
Methods
This retrospective audit reviewed 100 consecutive CT scans conducted out of hours in Sep 2015. Data
was collected using PACS along with patient notes. Data was analyzed to determine:
• whether a change in management resulted • whether any change in management occurred
before the next available in-hours routine examination
• whether there was a recorded confirmation of the provisional diagnosis.
Results
Conclusion
Overall change in management is observed in 65% of Patients but in 45% not before the next available
in hours examination. In addition, even provisional diagnosis could not be confirmed in 25% despite
CT requests done on urgent basis. From these findings it is questioned whether it is warranted for the
scan to be done urgently outside social hours? It is proposed to re-audit after 6 months followed by
intervention (teaching sessions on role of CT in emergency situations, & educational posters) whereby
in that trial period only Specialists and consultants can make the imaging requests.
References:
Charny MC et al. Out of hours radiology, a suitable case for audit? Br J Radiol 1987;60:553 6.
1. Registrar Nuclear medicine unit, KFSH, Buraidah, Kingdom of Saudi Arabia
2. Head Radiology Department, KFSH, kingdom of Saudi Arabia,
drabdulrehmantahir@gmail.com
dralaakhalifa1@gmail.com