UC emergency physicians safely eliminate thousands of unnecessary CT scans

An emergency medicine-led initiative has helped the University of Cincinnati eliminate thousands of unnecessary computed tomography (CT) scan requests, saving about $6.2 million, as Radiology Business recently reported.

While CT is invaluable for detecting life-threatening injuries in the emergency department, imaging of the head and cervical spine often provides little value for low-risk trauma patients. This can expose individuals to unnecessary radiation, increase costs and create inefficiencies in already overburdened EDs, College of Medicine physician-researchers wrote in the Western Journal of Emergency Medicine.

Read the UC News story about the published research.

They recently championed a new quality initiative to address this issue. It included continuing education sessions that reinforced for clinicians the occasions when ordering a CT scan provides little value. As part of the project, UC embedded clinical decision-support software into its electronic health record to help referrers avoid unnecessary requests.

"Not everyone with a head or neck injury needs a CT scan. Some do; some don't," said co-senior author David Thompson, MD, an associate professor of clinical emergency medicine and director of quality improvement and patient safety. "We strive to provide the right care for every patient, and we have the tools to make those decisions."

UC's study involved the emergency departments at UC Medical Center and West Chester Hospital during a 23-month intervention period. Researchers also focused on educating patients, especially those who insisted they needed a CT scan despite their doctor's determination.

Thompson and colleagues estimated that the practice change avoided more than 3,500 head and cervical CT scans. At an estimated cost of $1,750 per scan, this saved about $6.2 million in patient healthcare costs. In addition, UC avoided about four hours of wait time per scan, for a total of nearly 14,200 hours saved. On top of that, patients avoided over 6,000 millisieverts of radiation, and no patient harm was identified due to the skipped scans.

"We do not miss serious injuries if you follow these guidelines," said Thompson. "There is no downside. Indeed, we did not find a single missed injury when we reviewed our data."

Read the complete Radiology Business report.

Featured image at the top: Patient laying on a CT scan platform. Photo/iStock/baranozdemir.

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