A Multiobserver Study of the Effects of Including Point-of-care Patient Photographs with Portable Radiography: A Means to Detect Wrong-patient Errors

• Type of Material: Article
• Authors: Pamela Bhatti, Emory University; Srini Tridandapani, Emory University; Senthil Ramamurthy, Emory University; James Provenzale, Emory University; Nancy A Obuchowski, Cleveland Clinic Foundation; Michael G. Evanoff, The American Board of Radiology
• Language: English
• Date: 2014-08-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 AUR. CC BY NC ND 4.0
• Final Published Version (URL): http://dx.doi.org/10.1016/j.acra.2014.03.006
• Title of Journal or Parent Work: Academic Radiology
• ISSN: 1076-6332
• Volume: 21
• Issue: 8
• Start Page: 1038
• End Page: 1047
• Grant/Funding Information: Pamela Bhatti, PhD, was supported in part by the PHS grant (UL1 RR025008, KL2 RR025009) from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources.; Srini Tridandapani was supported in part by Award Number K23EB013221 from the National Institute of Biomedical Imaging and Bioengineering and in part by PHS grant UL1 RR025008 from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources.
• Keywords: CHEST RADIOGRAPHS; DICOM; Radiology, Nuclear Medicine & Medical Imaging; PACS; medical errors; Science & Technology; digital photography; ENVIRONMENT; Patient identification; RECOGNITION; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Radiology; Health Sciences, Epidemiology

Abstract

Rationale and Objectives: To evaluate whether the presence of facial photographs obtained at the point-of-care of portable radiography leads to increased detection of wrong-patient errors. Materials and Methods: In this institutional review board-approved study, 166 radiograph-photograph combinations were obtained from 30 patients. Consecutive radiographs from the same patients resulted in 83 unique pairs (ie, a new radiograph and prior, comparison radiograph) for interpretation. To simulate wrong-patient errors, mismatched pairs were generated by pairing radiographs from different patients chosen randomly from the sample. Ninety radiologists each interpreted a unique randomly chosen set of 10 radiographic pairs, containing up to 10% mismatches (ie, error pairs). Radiologists were randomly assigned to interpret radiographs with or without photographs. The number of mismatches was identified, and interpretation times were recorded. Results: Ninety radiologists with 21±10 (mean±standard deviation) years of experience were recruited to participate in this observer study. With the introduction of photographs, the proportion of errors detected increased from 31% (9 of 29) to 77% (23 of 30; P=.006). The odds ratio for detection of error with photographs to detection without photographs was 7.3 (95% confidence interval: 2.29-23.18). Observer qualifications, training, or practice in cardiothoracic radiology did not influence sensitivity for error detection. There is no significant difference in interpretation time for studies without photographs and those with photographs (60±22 vs. 61±25seconds; P=.77). Conclusions: In this observer study, facial photographs obtained simultaneously with portable chest radiographs increased the identification of any wrong-patient errors, without substantial increase in interpretation time. This technique offers a potential means to increase patient safety through correct patient identification.