Discrepancy rates in reporting of acute stroke CT.

INTRODUCTION: With increasing after-hours workloads there has been reliance on registrars to report after-hours acute stroke CT scans at our institution. This practice was reviewed for the perceived possibility of error and poor patient outcomes by the reliance on after-hours registrar reports. Through an audit of 3 years of these studies, we proposed to investigate if our current practice is safe and whether it results in poor patient outcomes.

METHODS: Following ethics approval, all after-hours acute stroke CT scan reports from September 2012 to August 2015 were identified using the PACS. All reports were reviewed with data recorded on a written worksheet then transferred to an Excel spreadsheet for analysis. The consultant report was used as the gold standard. In cases where discrepancies occurred, medical records were reviewed.

RESULTS: Eight hundred and ninety-four acute stroke CT scans were identified in the audit period with a subset of 316 studies identified where a registrar report was issued at time of scan and checked the following day by a radiology consultant. There were 114 discrepancies (10 were major, 51 were minor, and 53 other). In three discrepancy cases, the patient's clinical course was altered. There were no adverse outcomes as a result of a discrepancy. Using a radiology consultant as the gold standard the major discrepancy rate was ≈3% in the after-hours setting.

CONCLUSION: Our 3 year retrospective audit demonstrates that our practice of registrar report issued at the time of CT scan checked the following day by a radiologist has a low major discrepancy rate and that patient safety was not compromised. These results support the continuation of our current practice.