Requiring radiologists to review the X-rays of all trauma patients with fractured thigh bones or hips wastes millions of dollars, a recent study said.
The study, presented last month at the annual meeting of the American Academy of Orthopedic Surgeons, found that surgeons already had reviewed the X-rays and operated on patients long before radiologists analyzed the film.
In the 50 cases studied, radiologists generally read films 4.6 days to a week after the patient was injured and treated. They couldn't read X-rays immediately because surgeons needed the films in the operating room.
Orthopedic surgeons read the films correctly in all 50 cases; radiologists were accurate in almost all cases, the study said.
Most hospitals require radiologists to read all X-ray films to assure quality. However, accreditation standards require only that films be interpreted by physicians specifically authorized to do so, the researchers said.
The cost of radiologists reading X-rays of fractured femurs and hips equaled more than $46.8 million in 1989, they estimated.
The researchers are from Carolinas Medical Center, Charlotte, N.C.; Union Memorial Hospital, Baltimore; and R. Adams Crowley Shock Trauma Center, Baltimore.
Another study presented at the meeting examined the impact of a protocol for total joint replacements that covered procedures before, during and after the operation.
The protocol set quality controls for surgery and spelled out for nurses and staff when treatment, such as physical therapy, should start. In one approach, surgeons, nurses and physical therapists met with patients before surgery to explain what lay ahead and set goals for recovery. For 27 patients at White Plains (N.Y.) Hospital Center, the protocol cut mean hospital stays to 5.3 days from 10.1 days for hip replacements and to 5.6 days from 13.3 days for knee replacements.