TY - JOUR T1 - Implementation of a quality improvement initiative to reduce daily chest radiographs in the intensive care unit JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 379 LP - 385 DO - 10.1136/bmjqs-2015-004151 VL - 25 IS - 5 AU - Eric Sy AU - Michael Luong AU - Michael Quon AU - Young Kim AU - Sadra Sharifi AU - Monica Norena AU - Hubert Wong AU - Najib Ayas AU - Jonathon Leipsic AU - Peter Dodek Y1 - 2016/05/01 UR - http://qualitysafety.bmj.com/content/25/5/379.abstract N2 - Objective To reduce the number of routine chest radiographs (CXRs) done in a tertiary care intensive care unit (ICU).Methods Using a quality improvement approach, we measured the number of CXRs done per patient-day before (15 June 2010–15 June 2011) and after (15 June 2011–15 June 2012) a multipronged intervention in a 15-bed medical–surgical ICU in a 350-bed tertiary care teaching hospital. We studied a total of 1492 patients who were admitted to this ICU—738 patients during the preintervention period and 754 patients during the postintervention period. Interventions were education for the ICU house staff, developing indications for routine CXRs on the computer order-entry system, and visual posters/signage to remind ICU staff that there were no indications for routine, daily CXRs. The primary outcome was the number of CXRs per patient-day, but we also measured CTs of the chest, mechanical ventilator days, length of ICU stay and ICU and hospital mortality.Results There were 0.73 CXRs per patient-day done during the preintervention period and 0.54 CXRs per patient-day done during the postintervention period, a 26% reduction. There were no differences between the periods in age, sex or severity of illness (Acute Physiology and Chronic Health Evaluation (APACHE) II score) of the patients, number of chest CTs, mechanical ventilator days, length of ICU stay and ICU or hospital mortality.Conclusions A quality improvement that includes education, reminders of appropriate indications and computerised decision support can decrease the number of routine CXRs in an ICU. ER -