Emergency medicine physician-researchers at the University of Cincinnati have shown that a targeted quality improvement campaign can safely reduce unnecessary head and cervical spine (neck) computed tomography (CT) scans in low-risk trauma patients - with no downside.
In a study published recently in the Western Journal of Emergency Medicine , co-senior authors David Thompson, MD , and Anita Goel, MD , along with colleagues, reported that emergency departments at the University of Cincinnati Medical Center and West Chester Hospital avoided more than 3,500 unnecessary CT scans, saving patients more than $6 million in healthcare costs and avoiding more than 14,000 hours of waiting time and significant radiation exposure. The campaign identified no patient harm, and the data review found no missed injuries, confirming the approach's safety.
"UC physicians are committed to providing the best possible care and to continuously improving it," said Thompson, an associate professor of clinical emergency medicine and the director of quality improvement and patient safety in the College of Medicine 's Department of Emergency Medicine .
Guiding decisions
Research outcomes
By the end of the 23-month campaign, all outcome measures showed a reduction in the rate of head and cervical spine CT scans at both UC Medical Center and West Chester Hospital. No missed injuries were identified, confirming that the avoided scans were medically unnecessary.
"The doctors and the patients really want the same thing here," said Thompson. "We know patients want the highest quality care possible, and we are committed to providing the right testing and the right care needed in each situation."
High-volume hospital
As the Greater Cincinnati region's only academic medical center and Level I adult trauma center, UC Medical Center is a major tertiary care center and a high-volume hospital. The emergency department has 81 patient beds, which Thompson said are almost always at capacity - demonstrating that evidence-based imaging reduction can drive real-world quality improvements even in the busiest clinical settings.
"Achieving these decreases in such a high-volume setting makes the results particularly significant. This project was a huge win-win for doctors and patients," said Thompson.
UC study collaborators include co-senior author Anita L. Goel, MD, associate professor of clinical emergency medicine; co-first authors Jude C. Luke, emergency medicine resident physician, and Rebecca N. Kubick, medical student; Heidi J. Sucharew, emergency medicine research professor; Natalie E. Kreitzer, associate professor of clinical emergency medicine and interim vice chair of research in the Department of Emergency Medicine; and Kayla Winkler and Mary L. Giles from the UC Health Office of Performance Improvement.
Featured image at the top: Patient laying on a CT scan platform. Photo/iStock/baranozdemir.
Frequently asked questions about UC's CT scan reduction study
What did the UC study change about CT scans in the emergency department? right arrow down arrow
The quality improvement campaign encouraged emergency physicians at UC Medical Center and West Chester Hospital to reduce head and cervical spine CT scans for low-risk trauma patients, using evidence-based criteria to determine when imaging was truly necessary.
How many CT scans were avoided, and what was the impact? right arrow down arrow
During the campaign, an estimated 3,542 CT scans were avoided, preventing about $6.2 million in unnecessary patient charges, saving more than 14,000 hours of patient waiting time and avoiding more than 6,000 mSv of radiation exposure.
Was it safe to reduce CT scans? right arrow down arrow
Yes. The safety review found no patient harm, suggesting that the avoided scans did not affect patient outcomes and were not medically necessary.
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