Striving for excellence: multicentre quality improvement project to optimize CT KUB technique in renal colic patients

Abstract

Objective To perform audit of imaging practice in different hospitals to assess their adherence to guidelines on optimizing computerized tomography of kidneys, ureter and bladder (CT KUB) technique in order to reduce unnecessary scan length. To assess improvement in adherence to guidelines after intervention, following education of the technologists. Material and methods There were 12 participant radiology departments in eight cities of Islamic Republic of Pakistan. Findings of first audit round were presented in respective departmental meetings and technologists were educated. Second round was performed after 12 weeks. Our target was to achieve 100% compliance to standards. Comparison of adherence to guidelines before and after intervention was done. Total number of axial slices of KUB CT scan, images above upper pole of highest kidney (overscan/unnecessary slices) and percentage of unnecessary images were recorded. To calculate statistical significance of difference, Fischer exact and Chi-square tests were applied. Results Percentage of patients with appropriate CT KUB technique according to RCR guidelines was far less in first round (0-64%). It significantly improved after educating the technologists (35.57- 90.90%). Conclusion By following standard practice of CT KUB scan, significant radiation dose reduction is achievable without compromising diagnostic details. Advances in knowledge Standardization of CT KUB examination technique can valuably contribute to reduction in unessential radiation exposure