Annals of emergency medicine
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Emergency and radiology department directors at 517 acute-care US teaching hospitals were sent identical questionnaires surveying practice patterns of ED plain film radiograph interpretation. Fifty-seven percent of ED directors and 51% of radiology department (RD) directors responded. Both groups reported that the most common practice pattern (60%) was alternating responsibility for immediate interpretation between emergency physicians and radiologists during a 168-hour week. ⋯ Interpretation discrepancy rates between emergency physicians and radiologists were estimated to be 4% to 6%. The large amount of variation among hospitals in ED radiograph interpretation systems suggests that these systems were not designed with quality of care concerns as their primary criterion. As a consequence, objective patient outcome and process measures need to be developed and measured to ensure that a particular internal system for ED radiograph interpretation is providing an acceptably high standard of patient care.
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Because emergency medicine is a broad-based specialty, there is much leeway in the structure of resident education. The monthly block curriculum is a major determinant of the overall residency training experience. The purpose of our study was to define the block curricula of the accredited emergency medicine residencies in the 1986-87 academic year. ⋯ Nearly all programs offered rotations in the adult ED, a surgical subspecialty, critical care, and an elective during residency training. The percentage of rotations requiring direct supervision by emergency physicians increased threefold by the PG4 year. Off-service rotations dropped 15-fold during the PG4 year relative to the PG1 year.(ABSTRACT TRUNCATED AT 250 WORDS)