Quality improvement project can reduce pediatric head CT use
Rebecca M. Jennings, M.D., from Seattle Children's Hospital, and colleagues implemented a validated head trauma prediction rule for traumatic brain injury to assess a QI project in a community emergency department aimed at decreasing the use of head CT scans in children. Key drivers of CT use were identified and decision aids were implemented to improve the use of prediction rules. Maintenance of Certification credit and QI coaching were offered to hospitals. The effect of the intervention on monthly CT scan rates was assessed.
The researchers found that during the baseline period, the CT scan rate was 29.2 percent among 695 patients. After the intervention, the CT scan rate was 17.4 percent among 651 patients (P < 0.01). Targeting providers with variable pediatric experience and parental imaging expectations were identified as barriers.
"We demonstrate that a Maintenance of Certification QI project sponsored by a children's hospital can facilitate evidence-based pediatric care and decrease the rate of unnecessary CT use in a community setting," the authors write.
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