How should radiology critical results be communicated?
The short answer
Critical results should be called directly to a responsible caregiver, not left in the report for someone to find. The receiver reads the result back, and the radiologist documents the name, role, date and time of the call. The Joint Commission’s National Patient Safety Goals require hospitals to report critical results on a timely basis, and the ACR’s communication practice parameter sets the expectations for radiologists.
- 15 minTeleRads critical call standard
- Read-backon every call
- Name · role · timelogged for every call
What counts as a critical result
Each hospital defines its own critical results list, usually with its radiology group and medical staff. Lists commonly include:
- Acute intracranial hemorrhage or a new mass effect
- Large-vessel occlusion on CT angiography
- Tension pneumothorax or a large new pneumothorax
- Pulmonary embolism
- Aortic dissection or rupture
- Free intraperitoneal air or bowel obstruction with signs of ischemia
- Ectopic pregnancy or testicular or ovarian torsion
A teleradiology provider should read and follow your list, not its own.
The standards behind it
- Joint Commission
- National Patient Safety Goal NPSG.02.03.01: report critical results of tests and diagnostic procedures on a timely basis.
- ACR
- The ACR Practice Parameter for Communication of Diagnostic Imaging Findings expects direct communication of findings that need immediate action, and documentation of that communication.
- Your hospital policy
- Defines the list, who may receive calls, the time frames and how calls are documented.
A good critical call, step by step
- 01
Recognize
The radiologist identifies a finding on your critical list while reading.
- 02
Call directly
The radiologist calls the ordering provider or the responsible caregiver, not a general voicemail.
- 03
Read back
The receiver repeats the finding back so both sides know it was heard correctly.
- 04
Document
The report records the name and role of the person told, the date and the time.
- 05
Report monthly
Every call appears on a monthly log the hospital can audit.
Why critical calls go wrong at night
Where calls break down
- The result is in the report but nobody is called
- The call goes to a general voicemail or a switchboard
- No read-back, so a laterality or level error isn’t caught
- No record of who was told, or when
- The reader can’t be reached when the ED calls back
What prevents it
- A direct call for every finding on your list
- A named receiver: the ordering provider or the responsible caregiver
- Read-back on every call
- Name, role, date and time in the report
- One number answered by a person, all night
How TeleRads does it
- Critical results called within 15 minutes to your ED or the responsible caregiver.
- Read back on every call, so the finding is confirmed.
- Logged with name, role and time of the person who took the call.
- Your critical results list, loaded before go-live.
- One number answered by a person when your team needs to reach the reader.
- A monthly scorecard with every critical call, call by call.
See how this plays out on a real-looking case in our sample reads, or read about stroke imaging turnaround and OP-23.
Questions
What is a critical result in radiology?
An imaging finding that needs immediate action, such as an intracranial bleed, large-vessel occlusion, tension pneumothorax or pulmonary embolism. Each hospital defines its own list.
What does the Joint Commission require for critical results?
National Patient Safety Goal NPSG.02.03.01 requires hospitals to report critical results of tests and diagnostic procedures on a timely basis, under the hospital’s own policy.
How fast does TeleRads call critical results?
Within 15 minutes. The receiver reads the result back, and the call is logged with the name, role and time of the person who took it.
Does TeleRads use our hospital’s critical results list?
Yes. Your list is loaded before go-live, and every call follows it.
Can we audit critical calls?
Yes. Every critical call appears on your monthly scorecard, call by call.