As an EM resident, I often call the radiology resident for a verbal wet read as do many of my fellow co-resident. We are encouraged and expected to review our own films, but during period of high clinical activity or when the patient is unstable, it is not possible to get to a PACS computer to sit and review all chest x-rays and CT scans on our own while medically managing the patient. In the last few months, I've called for a read on a CXR. Sometimes, the resident or attending in radiology will pull up the last image, and give a wet read. However, I will find out that the patient's image has not yet loaded, so I receive a read on an old Xrays, and have discharged or administered a medication based off an old chest xray read. Thus far, no adverse outcomes or patient harm occured in these 2 instances, but I can imagine that it could result in great patient harm. 

The typical Radiology/EM resident interaction will entail me asking for a wet read, and the resident will provide it and then the radiology resident will always ask for my last name, so they can dictate, "verbal read given to Dr. Amin." I propose adding one extra step in this interaction which the radiology resident is expected to say the date and time of the image when asking for my last name.

For example, if the radiology resident or attending used the exact phrase, "this is for CXR take on 2/6/14 at 1:30pm...patient has bilateral interstitial infiltrates with mild cardiomegaly... no pneumothorax... etc.... Can I please get your last name?"

In the ED we use the IPASS system for sign out to help prevent loss of information or misinformation during patient hand off. I beleive creating a formal interaction process between the radiology department and emergency department will improve communication of imperative medical information.