Background/Introduction
The National Institute of Health and Care Excellence (NICE) guidance and The Royal College of Radiologists iRefer referral guidelines advise against Lumbar spine X-ray in the management of non-specific low back pain.1,2 iRefer limits the indication of X-ray only if osteoporotic collapse in the elderly is suspected.2
Reducing inappropriate lumbar spine X-rays will reduce unnecessary radiation burden,
reduce workload on local radiology departments,
shorten the waiting time for appointments and associated costs to clinical commissioning groups (CCGs).
Description of activity and work performed
Standard,
indicator and target: 100% of patients should satisfy the NICE and iRefer criteria.
Methodology:Clinical information was obtained from request information interrogated from computerised radiology information system (CRIS).
Patients who had lumbar spine X-rays in April 2014 – before request return with a clarification letter to the requester,
and in November 2014 – after implementation of imaging guidelines circulated to GPs.
Results of 1st audit round: April 2014 – 333 radiographs performed; 32 (10%) met imaging guidelines.
The majority (229) were for non-specific low back...
Conclusion and Recommendations
1st action plan:we obtained departmental agreement to return request cards to general practitioners (GPs) with a letter referencing the guidelines to accompany returned request cards to explain why the study had not been performed.
2nd action plan:We plan to;
Use implementation of order comms to add clinical guidelines at time of requesting to filter and audit filter success.
Continue return of request card.
Inform colleagues of success – as it creates extra work to reject order/return card.
Community hospital education as radiographers vetting have not...
Personal/Organisational information
Dr Al Nasiri is a GP and Dr Rowlands is a Consultant Radiologist and we were working together to ensure the patients across the region got a safe,
consistent approach to imaging of a common condition.
The Shrewsbury and Telford Hospital covers a large geographical area in the west of England of over 520,000 patients including 2 main hospitals and several community hospitals which provide imaging.
References
1.
National Institute for Health and Clinical Excellence.
Low back pain: early management of persistent non-specific low back pain.
Full guideline. London: National Institute for Health and Clinical Excellence,
2009.
2.
The Royal College of Radiologists.
iRefer: making the best us of clinical radiology, Seventh edition.
London: The Royal College of Radiologists,
2012.
