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EP30630
Poster Title: An Audit of Open Access CT Scanning at Hampshire Hospitals Foundation Trust
Submitted on 07 Nov 2019
Author(s): Dr W.M.N. Malalasekera, Dr E. Y. Auyoung, Dr P. Gnanananthan and Dr C. Vandervelde
Affiliations: Hampshire Hospitals Foundation Trust
This poster was presented at BIR Annual Congress 2019
Poster Views: 217
Submitted on 07 Nov 2019
Author(s): Dr W.M.N. Malalasekera, Dr E. Y. Auyoung, Dr P. Gnanananthan and Dr C. Vandervelde
Affiliations: Hampshire Hospitals Foundation Trust
This poster was presented at BIR Annual Congress 2019
Poster Views: 217
Abstract: With radiology’s central role in modern medicine early access to radiological investigations provides the potential for streamlined identification of patients who require secondary care referrals at the primary care level as a way of reducing pressure on secondary care services.
Hampshire Hospitals Foundation Trust has recently opened two open access CT pathways for primary care aimed at streamlining management of patients with renal colic, chronic headaches and possible subdural haematomas. In this audit we examined 232 CT head and KUB open access requests (from July-December 2018) for their indications and findings. The indications were compared against trust guidelines for the two types of investigation. 91.8% of CT KUB requests were for appropriate indications (i.e. symptoms of renal colic) while 81.6% of CT Head requests were appropriate (i.e. chronic headache without red flag features or possible subdural haematomas which could be managed in the community). We also identified that patients under 30 years old were substantially less likely to have renal stones identified on a CT KUB compared to other age groups.
Based on our findings we have implemented various changes to both pathways to clarify the indications and age criteria for each pathway. This includes the signposting of painless haematuria toward the 2-week-wait CT urogram pathway, cognitive decline towards older person’s mental health referral and suggesting alternative investigation modalities for renal colic in patients under 30. The pathways have also been expanded within North Hampshire area and are currently being re-audited to evaluate the efficacy of the changes made.
Summary: In this audit we looked at the appropriateness of open access CT requests in the North Hampshire area. We identified systematic causes for inappropriate requests for both CT Heads and KUBs and then implemented changes which improved requesting appropriateness,References: N/A
Hampshire Hospitals Foundation Trust has recently opened two open access CT pathways for primary care aimed at streamlining management of patients with renal colic, chronic headaches and possible subdural haematomas. In this audit we examined 232 CT head and KUB open access requests (from July-December 2018) for their indications and findings. The indications were compared against trust guidelines for the two types of investigation. 91.8% of CT KUB requests were for appropriate indications (i.e. symptoms of renal colic) while 81.6% of CT Head requests were appropriate (i.e. chronic headache without red flag features or possible subdural haematomas which could be managed in the community). We also identified that patients under 30 years old were substantially less likely to have renal stones identified on a CT KUB compared to other age groups.
Based on our findings we have implemented various changes to both pathways to clarify the indications and age criteria for each pathway. This includes the signposting of painless haematuria toward the 2-week-wait CT urogram pathway, cognitive decline towards older person’s mental health referral and suggesting alternative investigation modalities for renal colic in patients under 30. The pathways have also been expanded within North Hampshire area and are currently being re-audited to evaluate the efficacy of the changes made.
Summary: In this audit we looked at the appropriateness of open access CT requests in the North Hampshire area. We identified systematic causes for inappropriate requests for both CT Heads and KUBs and then implemented changes which improved requesting appropriateness,References: N/A
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