Emergency Radiology: Increasing demand on out-of-hours radiology department resources

Abstract

Aims
Demand for acute radiology services has increased globally, including in Ireland. Radiology Specialist Registrars (SpRs) play a significant role in managing this workload. However, rising demand can influence workflow, performance, and service delivery. Understanding workload trends is essential to ensure high-quality care. This study evaluates trends in out-of-hours imaging workload for radiology SpRs in a tertiary referral centre over a five-year period. The analysis includes the volume of computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) studies, as well as the number of incoming phone calls.

Methods
A retrospective observational analysis of imaging studies performed out-of-hours between 2019 and 2023 was performed. The mean number of studies in representative months of January, June, and November was calculated. Phone call volumes during selected periods were also assessed. Paired t-tests were used, with significance set at p<0.05.

Results
Mean out-of-hours CT increased from 694 in 2019 to 962 in 2023, a 39% increase (p=0.003). Emergency department (ED) studies increased by 46% (p=0.002). Significant increases were observed in CT TAP (220%, p=0.049) and NCB (38%, p=0.007). Stroke protocol CTs increased by 41% (p = 0.056). Studies performed after midnight increased by 82% (p=0.055). Out-of-hours MRI increased by 7% (p=0.76). US decreased by 41% (p=0.21). Phone calls to SpRs remained stable over the study period, averaging 33 calls per shift.

Discussion
The findings demonstrate an increased demand in out-of-hours CT and MRI, driven by increasing ED demand. US trends were not statistically significant, which may suggest shifting imaging priorities. Workflow management, sufficient staffing, and adequate support are crucial to address rising demand and maintain high standards of care.