Nighthawk (vRAD)

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 and plain film studies from ED with essentially negative resident reads, for which ED faculty want an overrread prior to discharge. Additionally, inpatient trauma spine studies that have been interpreted by the radiology resident as essentially negative, for which radiology overreads are needed to advance overnight care.

vRAD reports are sent as an image into PACS within the study, and faxed to the ED.

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

Clarifications of findings, studies on other 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.

vRAD Operations center: 866-941-5695 (Toll Free)

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 can be determined on a case by case basis.  

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 preliminary resident read should be in the Study comments ("I"box).  Residents generally request "tiebreaker" reads from faculty at the request of the ED.

ED Responsibility:

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

The ED will receive faxed copy of the nighthawk read which will be scanned into EPIC.

 

 

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