Posters for accident departments: simple method of sustaining reduction in x ray examinations

摘要

Objective—To assess whether a simple strategy would sustain a reduction in the number of unnecessary x ray examinations. Design—Use of posters to display guidelines encouraging the more effective use of radiology in patients with head injuries, twisted ankles, neck injuries, and abdominal pain. Setting—Accident department of a large metropolitan district general hospital. Patients—15875 patients attending the accident department over two years. Main outcome measure—Proportion of patients having radiography. Results—Referrals for skull radiography fell from 56% to 20% and those for abdominal radiography fell from 31% to 7%. Referral patterns for adults attending with twisted ankles and cervical spine injuries did not change. Reductions were sustained over two years. Conclusion—Carefully designed posters provide a simple method of reducing unnecessary x ray examinations.