COTTAGE HEALTH SYSTEM POLICY

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SUBJECT:

TRANSITION OF CARE - Radiology Residents

 

DEPT: MEDICAL EDUCATION
POLICY #: 8240.13

 

GOAL

To provide guidelines for effective transitions of care for radiology residents.

 

POLICY

Transitions in direct patient care are relatively rare in the practice of radiology. Because the majority of radiologic practice involves image interpretation, direct patient care of a length requiring transition of care is generally limited to the setting of post-procedural observation (for example, monitoring of patients for pneumothorax following lung biopsy). In the majority of cases, the time of observation still is of a short length, and periods of observation usually do not span greater than a single shift.

 

However, the concept of transfer of care may also be applied to the transfer of patient information, a situation that applies more frequently than the situation above in radiologic practice. Pending scans or procedures are often discussed with referring clinical services, and important information regarding patient history conveyed. The transfer of this information at change of shift is important for proper protocoling of radiologic examinations, for informed interpretation of images obtained, and proper triaging and performance of imaging guided interventional procedures or fluoroscopic examinations.

 

Transitions of care are minimized in order to minimize miscommunications.

 

PROCEDURE

Transitions of care occur in the radiology department daily:

1.   At the start of the day, the radiology resident completing an overnight call shift transitions care to the members of the department covering the various radiologic services for the workday.
    a.   The post call resident reviews the results of all imaging studies which he/she reviewed overnight with the assigned attending staff. At this time, results conveyed to referring clinical services and relevant clinical histories applying to each case are communicated with the attending staff. Following this discussion, the resident amends reports and places appropriate phone calls to referring clinical services in situations where the overnight interpretation of the exam and the final attending read differ. Appropriate voice clips are placed on the PACS system for each case before the post call resident leaves the hospital.
    b.   The post call resident is also responsible for conveyance of information regarding upcoming procedures or imaging studies to the individual responsible for the relevant radiology service. This individual could include either a resident or an attending staff member.
2.   At the end of the workday, radiology residents and staff covering individual services are responsible for communication of information to the resident and/or attending staff covering the evening shift. 
3.   At the end of the evening shift, the attending staff performing the shift is responsible for communication of information to the overnight call resident. 


Conveyance of information during transitions of care outlined above will be performed verbally, with review of any relevant imaging studies, at the time of change of shift. Important information includes:

1.   Patient history of contrast allergy
2.   Clinical indications for upcoming studies which require specific tailoring of exams to be performed (for example, need for multiphasic CT of the liver in a patient with suspected hepatocellular carcinoma rather than the standard portal venous phase exam)
3.   Patient history pertinent to tailored interpretation of exam findings
4.   Indications for and specific information pertinent to fluoroscopy examinations and imaging guided (interventional) procedures
5.   History regarding any patient undergoing active monitoring for post procedural complications following imaging guided procedures

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COTTAGE HEALTH SYSTEM POLICY


RECOMMENDED BY: S. Snodgress, MD DATE: 7/11

ORIGINAL POLICY EFFECTIVE DATE: 7/11

APPROVED BY: E. Wroblewski, MD DATE: 7/11

DATE REVISED:
DATE REVIEWED: