Short- and long-term effects of clinical audits on compliance with procedures in CT scanning

Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

doi:10.1007/s00330-015-4100-x

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…First, regarding the impact of surveying compliance, our findings are consistent with those reported by Oliveri et al showing an increased compliance after informing the staff [10]. However, they also demonstrate that the compliance which proved to be stable at one year, decreased thereafter.…”

Section: These Observations Deserve Further Discussionsupporting

confidence: 92%

“…To investigate the ideal audit repetition interval, we compared our data with those of Oliveri et al whose paper focused on hospitals B and C in the same hospital group [ 10 ]. Since then, the institution has gone through changes with both a fusion and a reorganization of the department.…”

Section: Methodsmentioning

confidence: 99%

“…The aim of this study was therefore to monitor compliance to the procedure in two distinct steps: a baseline observation before reminding the radiology staff of the procedure, and an assessment after renewed attention, and to compare it with the observation obtained five years earlier [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Audit on Compliance to Guidelines in CT Scanning for Urolithiasis

Defrenne

Howarth

Tack

2022

Journal of the Belgian Society of Radiology

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Introduction:According to the ALARA principle, CT-imaging procedures should be implemented to optimize radiation doses. The purpose of this study is to determine whether a quality control process has an impact on compliance with procedures. Materials and methods:This retrospective study was conducted in three hospitals, focusing on the selection of the appropriate acquisition protocol and the reduction of acquisition height in abdominal computed tomography (CT) examinations performed to diagnose or rule out urolithiasis. A first audit was conducted to measure the compliance with the procedure. Next, a reminder of the CT-urolithiasis procedure was given to stakeholders. Three months later, a second audit was conducted to measure the impact of the repeat recall information on compliance, and to compare the outcome with an earlier audit conducted five years earlier. Results:We included 517 'urolithiasis CT examinations'. The compliance ranged from 41.67% to 64.8% for the first audit. After the reminder of the urolithiasis procedure, compliance ranged from 50% to 76.10%. This improvement was statistically significant for hospital A and B (p < 0.001 for hospital A, p = 0.013 for hospital B) but not for hospital C (p = 0.405). Despite prior demonstration that improved compliance persisted at one year from an initial audit, our actual data show that this compliance had decreased at year five, confirming the need to repeat compliance audits more frequently, or to monitor it continuously. Conclusion:Surveying compliance to procedures can improve compliance but only for a limited duration. Monitoring compliance more frequently or even continuously is recommended.

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Section: These Observations Deserve Further Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

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Audit on Compliance to Guidelines in CT Scanning for Urolithiasis

Defrenne

Howarth

Tack

2022

Journal of the Belgian Society of Radiology

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“…The attenuation-based automatic kilovolt-selection exists, but it is not available on all scanners. 28 For obese patients (BMI > 30 kg/m 2 ), Kalra et al 29 recommended a 2-fold increase in tube current-time product and an image noise that is greater than for a standard adult in normal-dose abdomen and pelvic CT. Manowitz et al 30 increased the effective dose from 1.3 to 2.0 mSv in patients with a BMI greater than 35 kg/m 2 to have satisfactory IQ in a lung cancer screening program. Corresponding clinical data for the model-based algorithm respecting soft tissue imaging for chest CT are not available in the literature.…”

Section: Discussionmentioning

confidence: 99%

Submillisievert Computed Tomography of the Chest Using Model-Based Iterative Algorithm

Deák

Maertz

Meurer

et al. 2017

Journal of Computer Assisted Tomography

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“…Education addressing current CT scan range extension in one body region 8 and operator surveys, 18 combined with periodical clinical audits 11 (using a simplified audit tool), is known to create reductions in radiation dose and strengthening of clinician standards 23‐28 . Another study by Badawy et al noted a 15% reduction rate in the frequency of CT neck over‐scanning, a 33% reduction in the average CT over‐scanning extent and a 20% dose reduction globally, following education on radiation awareness and dose optimisation targeting neck CT 19 .…”

Section: Clinical Suggestions For Greater Compliance To Scan Extentmentioning

confidence: 99%

The proportion of computed tomography kidneys, ureters and bladder (CTKUB) scans that comply with scan extent protocol in an emergency department: a clinical audit and dose ramification study

Kasi

Steffens

Starkey

et al. 2020

J of Medical Radiation Sci

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Introduction To assess computed tomography kidneys, ureters and bladder (CTKUB) scan extent protocol compliance and associated doses in the Emergency Department (ED) of an Australian tertiary hospital. Methods A retrospective clinical audit of 150 consecutive ED CTKUB cases was completed. For each patient, scan extent compliance at the superior (kidneys) and inferior (pubic symphysis) borders, in reference to the protocol was recorded. Compliance and non‐compliance (over‐/under‐scanning) was identified, described (superior/inferior), quantified (via IMPAX measurements) and recorded via a purpose‐built audit tool. In addition, a PBU40 phantom was scanned to assess the percentage of dose (DLP) increase per centimetre of over‐scanning to contextualise results. Results A notable non‐compliance with department protocol was noted. Eight cases (5.3%) demonstrated overall CT scan extent compliance. The remaining 142 cases (94.7%) demonstrated some form of non‐compliance; superiorly, inferiorly or both. Analysing the 150 superior and 150 inferior data points independently, the most common non‐compliance was over‐scanning at the kidneys by 4 cm to5 cm (19 cases, ~10% extra DLP) beyond tolerance and over‐scanning inferiorly at the pubic symphysis by 1 cm to 2 cm (29 cases, ~6.4% extra DLP). Estimated dose increases of up to 35% to 45% were found when clinical audit results were simulated using a PBU40. Conclusions Over‐scanning is a predominant occurrence in CTKUB scans in this department. Reasons for over‐scanning weren't investigated. It's anticipated this audit will lead to greater awareness of scan extent compliance and dose ramifications of non‐compliance. The usage of more easily identified anatomical landmarks and a follow‐up audit is suggested.

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Short- and long-term effects of clinical audits on compliance with procedures in CT scanning

Cited by 5 publications

References 15 publications

Audit on Compliance to Guidelines in CT Scanning for Urolithiasis

Audit on Compliance to Guidelines in CT Scanning for Urolithiasis

Submillisievert Computed Tomography of the Chest Using Model-Based Iterative Algorithm

The proportion of computed tomography kidneys, ureters and bladder (CTKUB) scans that comply with scan extent protocol in an emergency department: a clinical audit and dose ramification study

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