How are our residents doing on trauma tonight? The frequency of overnight resident-faculty report discrepancies in trauma patients.

Abstract

To determine if preliminary radiology reports issued overnight (10pm to 7 am) on adult trauma patients cause major changes of high clinical significance or patient harm. Following extraction of preliminary and final radiology reports from the report server, presence of changes was determined by an automated text differential checker. If text changes were present, reports were then subsequently manually graded by an attending radiologist and placed in category by degree of severity. 81weeks of trauma report data were analyzed by two faculty radiologists. Of the 6063 preliminary reports from 1214 separate overnight trauma patients, 65.5% had no changes in final report text. The remaining reports were graded: A 8.9% (503), B 17.2% (1005), C 7.0% (426), and D 1.3% (100). No reports demonstrated a major change of high clinical significance (E) or patient harm (F). Most preliminary report changes were minor and had no clinical significance. Furthermore, the few that were deemed to be major changes were of little clinical significance, particularly in the setting of the other traumatic injuries that the patient may have sustained. No negative patient safety events were caused by an error in a radiology resident preliminary report.