Implementation of a quality improvement initiative to reduce daily chest radiographs in the intensive care unit

BMJ Quality & Safety
Eric SyPeter Dodek

Abstract

To reduce the number of routine chest radiographs (CXRs) done in a tertiary care intensive care unit (ICU). Using a quality improvement approach, we measured the number of CXRs done per patient-day before (15 June 2010-15 June 2011) and after (15 June 2011-15 June 2012) a multipronged intervention in a 15-bed medical-surgical ICU in a 350-bed tertiary care teaching hospital. We studied a total of 1492 patients who were admitted to this ICU-738 patients during the preintervention period and 754 patients during the postintervention period. Interventions were education for the ICU house staff, developing indications for routine CXRs on the computer order-entry system, and visual posters/signage to remind ICU staff that there were no indications for routine, daily CXRs. The primary outcome was the number of CXRs per patient-day, but we also measured CTs of the chest, mechanical ventilator days, length of ICU stay and ICU and hospital mortality. There were 0.73 CXRs per patient-day done during the preintervention period and 0.54 CXRs per patient-day done during the postintervention period, a 26% reduction. There were no differences between the periods in age, sex or severity of illness (Acute Physiology and Chronic Health Evaluation...Continue Reading

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Citations

Aug 3, 2019·Journal of the American Association of Nurse Practitioners·Yu WuPablo Moreno Franco
May 1, 2020·BMJ Quality & Safety·Christine SoongKaveh G Shojania
Jan 16, 2019·JAMA Network Open·Hayley B GershengornGordon D Rubenfeld
Aug 3, 2020·The Annals of Thoracic Surgery·Eleah D PorterJoseph D Phillips
May 2, 2018·The Journal of the American Osteopathic Association·Brian K YorkgitisGerald Weinhouse
May 8, 2021·Journal of the American College of Radiology : JACR·UNKNOWN Expert Panel on Thoracic ImagingJeffrey P Kanne

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