Procedure entrustment on-call: can radiology residents safely and independently perform hip aspirations after-hours?

Abstract

To evaluate the quality and safety of hip aspiration procedures performed by radiology residents on-call compared to those performed by supervised residents or attending radiologists during workday hours. Additionally, to identify potential areas for improving resident procedural exposure. A single-center retrospective study evaluating daytime and on-call hip joint aspirations performed on emergency or admitted patients from June 1, 2019, to May 31, 2020. Data collected included patient demographics, procedure times, performing staff, and procedural and surgical outcomes. The Mann-Whitney U-test was used to analyze quantitative data, and Fisher's exact test was used for categorical variables. Residents performed 19 (100%) of on-call procedures and 12/50 (24%) of daytime aspirations. On-call procedures had shorter median time from order to procedure start (115 compared to 294 min, p = 0.004) but overall longer median procedure durations (52 versus 32 min, p = 0.054). In total, 17/19 (89%) of procedures on-call versus 49/50 (98%) of daytime cases yielded sufficient sample for analysis (p = 0.18). Of these, 5/17 (26%) on-call and 16/49(34%) of daytime aspirates were culture-positive (p = 0.77). Resident-performed hip aspirations on-call were initiated more promptly but did not significantly differ in rates of aspirate yield or culture positivity. Residents performed only 24% of daytime cases, highlighting the opportunity to increase resident procedural exposure.