BackgroundTo determine the impact of a radiology electronic notification system (ENS) on emergency department (ED) patient care.Materials and MethodsA retrospective review of de-identified patient data for a 2-year period (1 year prior to and 1 year following ENS implementation) was approved by the hospital’s institutional review board. The effect of a radiology ENS on ED patient care was investigated by analyzing the intervals between completion of a chest radiograph and the times antibiotics were ordered/administered on patients presenting with symptoms of community acquired pneumonia (CAP). The square root transformation of the means was analyzed with an ANOVA model to determine statistical significance.ResultsDuring the 24-month study protocol, 1,341 patients who were evaluated in the ED met the study eligibility criteria. The least square estimates of the mean times from when the chest radiograph was completed to when antibiotics were ordered prior to and after the implementation of the ENS were 89 and 107 minutes, respectively (P < 0.01). The least square estimates of the mean times from when the chest radiograph was completed to when antibiotics were administered prior to and after the implementation of the ENS were 115 and 132 minutes, respectively (P = 0.02).ConclusionThe implementation of a radiology ENS does have advantages for the radiologist in streamlining the communication and documentation processes but may negatively impact time to treatment and thus patient care.

We report a case of a 16-year-old male who sustained a Lisfranc (tarsal metatarsal joint) fracture after a minor fall. His emergency department (ED) presentation, clinical course, and operative repair are presented as well as a discussion of Lisfranc fractures to include historical significance. Even after minor trauma, an emergency department physician must consider the often elusive diagnosis of a Lisfranc fracture in any patient with foot pain.

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