Deimplementation of Routine Chest X-rays in Adult Intensive Care Units.

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Silas P TrumboSunil Kripalani

Abstract

Choosing Wisely® is a national initiative to deimplement or reduce low-value care. However, there is limited evidence on the effectiveness of strategies to influence ordering patterns. We aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies. We aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies. The study was performed in the medical intensive care unit (MICU) and cardiovascular intensive care unit (CVICU) of an academic medical center in the United States from October 2015 to June 2016. The initiative included the staff of the MICU and CVICU (physicians, surgeons, nurse practitioners, fellows, residents, medical students, and X-ray technologists). We utilized provider education, peer champions, and weekly data feedback of CXR ordering rates. We analyzed the CXR ordering rates and factors facilitating or inhibiting deimplementation. Segmented linear time-series analysis suggested a small but statistically significant decrease in CXR ordering rates in the CVICU (P < .001) but not in the MI...Continue Reading

Citations

Jul 31, 2019·Current Opinion in Critical Care·Christopher M Fung, Robert C Hyzy
Jul 31, 2020·JAMA Internal Medicine·Jason H Maley, Jennifer P Stevens
May 11, 2021·Radiology. Cardiothoracic Imaging·Thomas J MariniKatherine A Kaproth-Joslin

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