Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Clinical Medicine Journal

  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Clinical Medicine Journal

clinmedicine Logo
  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Tackling delays in patients requiring chest X-rays on the acute medical take

Adam Bharmal and Tehmeena Khan
Download PDF
DOI: https://doi.org/10.7861/clinmed.20-2-s74
Clin Med March 2020
Adam Bharmal
ARoyal Free London NHS Foundation Trust, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tehmeena Khan
BUniversity College London Hospitals NHS Foundation Trust, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

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).

Fig 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 1.

Run chart demonstrating the improving proportions of patients receiving clinically indicated chest X-rays prior to their acute medical unit admission, with labels detailing timing of interventions and the corresponding plan, do, study, act cycle to which they belong.

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

  1. ↵
    1. British Thoracic Society
    . Guidelines for the management of community acquired pneumonia in adults update 2009. BTS, 2009. www.britthoracic.org.uk/document-library/clinicalinformation/pneumonia/adultpneumonia/a-quick-reference-guide-bts-guidelines-for-themanagement-ofcommunity-acquired-pneumonia-in-adults/ [Accessed 02 December 2018].
  2. ↵
    1. Naithani S
    , Whelan K, Thomas J. Hospital inpatients’ experiences of access to food: a qualitative interview and observational study. Health Expect 2008;11:294–303.
    OpenUrlCrossRefPubMed
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Tackling delays in patients requiring chest X-rays on the acute medical take
Adam Bharmal, Tehmeena Khan
Clinical Medicine Mar 2020, 20 (Suppl 2) s74-s75; DOI: 10.7861/clinmed.20-2-s74

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Tackling delays in patients requiring chest X-rays on the acute medical take
Adam Bharmal, Tehmeena Khan
Clinical Medicine Mar 2020, 20 (Suppl 2) s74-s75; DOI: 10.7861/clinmed.20-2-s74
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction and aim
    • Method
    • Results
    • Conclusion
    • Conflicts of interest
    • References
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Watchpoint: an NHS-grown electronic communication system shown to improve patient safety
  • A quality improvement project on improving the compliance of ‘oxygen prescription with target saturations’ in a district general hospital
  • Therapies in ACS: the pitfalls of prescribing
Show more Quality Improvement and Patient Safety

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home
clinmedicine Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians