Purpose or Case Report: Access to timely and accurate interpretation of imaging studies is critical to ensure quality care. This has driven demand for 24/7 radiology coverage. Examples of coverage models and solutions to logistical and financial challenges of providing around-the-clock real-time radiology services can be helpful as more children's hospitals move toward meeting this demand. The purpose of this exhibit is to describe the practice model used to provide after-hours pediatric radiology coverage at Cincinnati Children's Hospital Medical Center.
Methods & Materials: A description of the after-hours pediatric radiology coverage model at Cincinnati Children's Hospital Medical Center is provided including detailed discussion of:
- Staffing and scheduling
- Case volume and turn-around times
- Cost
- Integration of radiology residents and fellows
- Ongoing challenges
Results: Cincinnati Children's Hospital Medical Center utilizes 2 in-house emergency radiologists that work overnight shifts on a rotating schedule of 1 week on followed by 2 weeks off. The third week of the rotation is covered by a select group of rotating daytime radiologists who receive additional incentives. A pediatric radiology fellow is scheduled to work alongside staff each overnight. Early evening hours are covered by 2 daytime radiologists, a radiology resident, and pediatric radiology fellow.

Real-time interpretation is provided for imaging studies performed at the hospital's main campus as well as a satellite hospital and several regional urgent care centers. A turnaround time goal of <30 minutes is met for the majority of cases and volumes in the after-hours period allow for satisfactory revenue to expense ratios.
Conclusions: Cincinnati Children's Hospital Medical Center has developed an efficient system to provide timely and accurate delivery of after-hours pediatric radiology services that is critical to ensuring consistent around-the-clock quality patient care. Data on after-hours pediatric radiology coverage can help institutions design effective practice models.