Diagnostics
SickKids improves night coverage for DI
January 29, 2025
TORONTO – At the Hospital for Sick Children, a new team of doctors is working through the night to help the hospital’s medical teams get quick access to diagnostic imaging reports, with the goal of speeding up care for sick and injured kids.
Launched last May, the Division of Emergency Radiology ensures a dedicated doctor is at the hospital overnight to oversee diagnostic imaging, the Toronto Star reported.
The emergency radiologist helps co-ordinate imaging requests from the emergency department and inpatient units and is onsite to provide a final report on any X-rays, ultrasounds, CT scans and MRIs that need to be done between 8 p.m. and 8 a.m.
Previously, a staff radiologist – a doctor with the most experience – was on-call overnight, meaning a radiology resident or fellow would have to contact them with an urgent question and wait to get a response.
Now, a staff emergency radiologist works through the overnight hours, speaking directly with other medical teams at a moment’s notice, swiftly signing off on final imaging reports and offering more training to the hospital’s radiology residents and fellows.
Hospital leaders say the initiative – the first of its kind at a Canadian pediatric hospital – has been a success.
Eight months after its launch, they report: An increase in the number of X-ray and CT exams completed overnight. Less time between when a team requests a diagnostic image to when the exam starts. And a significant improvement in the turnaround times for imaging reports to be finalized and sent to medical teams.
Each of these gains has led to a better experience for patients and their families, said Christine Hill (pictured), clinical director of the hospital’s Department of Diagnostic & Interventional Radiology.
“Improving access to radiology expertise overnight … allows patients to be diagnosed more quickly and get the care they need as soon as possible.”
SickKids performs about 130,000 diagnostic imaging exams every year. About 20,000 take place between 8 p.m. and 8 a.m. Most of these nighttime exams are for patients who have come to the hospital’s emergency department for medical help.
A main reason SickKids created the emergency radiology division was to reduce delays and improve communication among teams during the overnight hours.
“It was taking much longer than we felt comfortable with to access imaging, to get reports from radiologists, to be able to communicate those plans of care between teams,” said Hill.
SickKids is a teaching hospital. and trainee doctors are key members of medical teams. Radiology residents and fellows can prepare preliminary diagnostic imaging reports and send them to physicians so they can start care plans for patients. A staff radiologist with more expertise then reviews and signs off on a final report, which can provide greater insight on more complex cases.
Since launching the new division, SickKids reports that the time it takes for a staff radiologist to sign off on a final report for a CT imaging exam has been reduced by 77 percent, from about seven hours to 1.6 hours, while the time to receive a final ultrasound report dropped by 81 percent, from about four hours to less than an hour.
For X-rays, the turnaround time for a final report went from about nine hours to slightly more than one hour.
“You can see how this helps to facilitate getting answers more quickly to the patients and families – being able to provide that treatment faster, or send them home, if it’s appropriate,” Hill said. “It’s making a big difference.”
Dr. Olivia Ostrow, director of quality and safety of pediatric emergency medicine, said the new division is having a positive impact on the hospital’s emergency department, especially since the ED is at its busiest through the night.
“Our highest patient volumes are in the evening, whereas diagnostic imaging resources have tended to decrease after normal business hours,” said Ostrow, noting that diagnostic imaging has typically been staffed more on a nine to five basis. With the new division, she said the streamlined communication between radiology and the ED has improved workflows, which means doctors have more time to spend with patients.
SickKids has three staff emergency radiologists, who alternate weekly overnight coverage. Hospital leaders say the investment has improved the well-being of staff radiologists, who previously were on call for long stretches and faced frequent sleep interruptions.
They also say that trainee doctors benefit from the overnight teaching and direct supervision.
Source: Toronto Star