A Toolkit for Pediatric CT Dose Reduction in Community Hospitals

Abstract

“Eighty percent of success is just showing up.”Woody AllenPediatric CT radiation dose optimization is a challenging process for pediatric-focused facilities and community hospitals alike. Ongoing experience and trial-and-error approaches to dose reduction in the large academic hospital setting may position these centers to help community hospitals who strive for CT quality improvement. In this pilot project, we describe our hands-on approach to develop a partnership between an academic medical center and a community hospital to develop a toolkit for implementing CT dose reduction. Our aims were to 1) assess the acceptability of an interactive educational program and electronic toolkit booklet, 2) conduct a limited test of the efficacy of the toolkit in promoting knowledge and readiness to change, and 3) assess the acceptability and practicality of a collaborative approach to implementing dose-reduction protocols in community hospitals. In partnering with the community hospital, we found that they had size specific radiation doses 2 to 3 times higher than those at our center. Survey results following a site visit with interactive educational presentations revealed an increase in knowledge, stronger opinions about the health risks of radiation from CT scans, and willingness and perceived ability to reduce pediatric CT doses.

A Simulation Paradigm for Evaluation of Subtle Liver Lesions at Pediatric CT: Performance and Confidence

“…Because of this high utilization, children's increased radiation sensitivity, and longer life expectancies (1), much attention has been placed on radiation safety. European diagnostic reference ranges (4), the Image Gently Campaign (5,6), and the ALARA (as low as reasonably achievable) principle aim to reduce radiation exposure, although variability persists for similar examinations (7,8).…”