Workflow Guidelines / Expectations for After Hours Work

Workflow Guidelines/Expectations for afterhours work

Expectations of the PM/On call readers:

All on call exams reviewed before the end of shift should be read. On call person (faculty or fellow) can help read studies if PM reader is backed up but should prioritize incoming exams.

Downtimes:

XC1 (before PM readers comes in) and PM readers are the primary contacts to make decisions regarding workflow during global downtime conditions (PACS outage, AA outage, snow days). They will coordinate information from everyone working that day and decide how to proceed- if a junior member is in that position, they would be expected to seek opinions from senior members to make decisions. Everyone acknowledges that these people will be making the best decisions they can with the knowledge they have available at the time.

Afterhours Inpatient Exams (after 3pm and on weekends):

Everyone should keep an eye on the list and prioritize stat/ED/Urgent care and inpatient exams, especially exams within their subspecialty during regular workdays. Afterhours, it is primarily the responsibility of the PM/On call rad to read inpatient exams.

Exception: Sometimes nonurgent inpatient exams are done afterhours or on the weekends (cancer workup, lesion workup, osteo feet/extremity, etc.). These should be checked, but no reason to read unless you are caught up and are comfortable reading it. No reason to contact anyone. If you think the exam requires a subspecialty read, assign to comm MSK/Body/Neuro as appropriate. IF there is a critical finding, rad should contact a provider and document findings either in PACS as a prelim or final report.

If you are called by a provider regarding a subspecialty case on an inpatient and review is requested, you should review the case and discuss any urgent findings. Rad should place a prelim in PACS and document the discussion- what was said, to whom and when.

If the provider requests a final report, rad can read the case with option (in the report) to state that an addendum will be placed after subspecialty review if needed.

If the rad is really in a bind, can text/message subspecialty readers with a call for help.