Tackling delays in patients requiring chest X-rays on the acute medical take
Introduction and aim
Chest X-rays form a vital part of the initial assessment and management of patients seen by medical practitioners.1 During the acute medical take at University College Hospital (UCH), patients are referred to the medical team by the emergency department (ED) team or via their general practitioner. Due to logistical arrangements, patients may be transferred to the acute medical unit (AMU) without the chest X-ray that they require as beds become available. As a result, patients would then be transferred to the X-ray department at a later time or date to have this crucial investigation when it could have been performed in ED at the time of admission. This can lead to delays in diagnosis and management, as well as unnecessary disruption for the patient. This quality improvement project was designed to tackle these delays in obtaining chest X-rays between October 2018 and March 2019.
Method
Electronic health records of 122 patients were analysed pre-intervention to determine the proportion that did not receive a chest X-ray prior to admission to the AMU. The delay in patients who had the X-ray after AMU admission was recorded. Two plan, do, study, act (PDSA) cycles with interventions focussed around improving communication between ED staff, acute medicine doctors and radiographers were performed. A further 135 patient records were analysed post-intervention to determine if there was any increase in the proportion of patients receiving an X-ray prior to admission and if that corresponded to a reduced delay.
Results
By the second cycle, the percentage of patients receiving their clinically indicated chest X-ray prior to admission to the AMU rose from 82% to 92%, with delay time reducing from 2 hours and 22 minutes per patient to 42 minutes per patient (Fig 1).
Conclusion
The results given above translate to reduced disruption for patients2 and reduced delays in diagnosis and management for patients admitted under medicine at UCH.
Conflicts of interest
None declared.
- © Royal College of Physicians 2020. All rights reserved.
References
- ↵
- British Thoracic Society
- ↵
Article Tools
Citation Manager Formats
Jump to section
Related Articles
- No related articles found.
Cited By...
- No citing articles found.