Workflow algorithm

Hours: 9pm-8am M-F. 5pm - 8am Sat-Sun-Holidays, calls will go to vRad for over-reads of resident interpretations. 

Which studies: CT and MR studies from ED with negative resident reads, for which ED faculty want an overrread prior to discharge.

"Tiebreaker" reads (discrepancy between resident and vRAD) that affect discharge or acute management go to the on call faculty.

Clarifications of findings, studies on in-patients, or questions from clinicians at OHSU that want to talk with fellow or faculty; all go to the fellow or faculty on call.


For the fellows/faculty:


Calls can still come from residents to fellows/faculty prior to any report being given to the ED.  Calls should come from the resident to faculty for overread requests (in order that resident can triage to most appropriate faculty) when the nighthawk read differs from the resident (negative) read.  Depending on the finding, possible effect on acute management, and ED faculty, a "tiebreaker" read may need to be made by the faculty (not fellow). 


Communication of the "tiebreaker" read would best be from Radiology faculty directly to ED faculty, but that is not set in stone. 

Documentation of the "tiebreaker" read in the Study Comments ("I"box) should be done at the time of the read, as the person reading the study the next day should have that information as well as the nighthawk read.

Resident responsibility:

The prelim resident read and the nighthawk read should be in the Study comments ("I"box).  Residents generally request "tiebreaker" reads from faculty at the request of the ED. Residents copy/paste the nighthawk read into the Study Comments ("I"box) before they leave in the morning. Tip: Open Impax and vrad on the same pc to facilitate copy/paste.

ED Responsibility:

ED HUC sends studies to nighthawk and requests read from nighthawk.

The ED will be getting a faxed copy of the nighthawk read which will be scanned into epic.



Manual home