Skip to main content

Appropriate Use of CT Scan in the Emergency Department

  • Chapter
  • First Online:
Lean Six Sigma Case Studies in the Healthcare Enterprise

Abstract

This chapter describes a case study in a community-based acute care hospital that was able to successfully reduce the Computed Tomography (CT) utilization in their Emergency Department by 8.7 % for 1 year, and 13.8 % since the prior 2-year period. The reduction was especially important because 10 % of the U.S. population gets a CT scan each year, and use of CT imaging is growing more than 10 % per year, and with it, increased long-term exposure can increase potential cancer risks. The cross-functional team applied the Six Sigma methodology and tools to define the problem, measure the current state, identify root causes, and develop medical research-based and evidence-based CT guidelines to reduce CT utilization. The information presented in this case study is not designed or intended to provide medical advice or recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Baumgarten, D. A., Francis, I. R., Bluth, E. I., Bush, W. H., Jr., Casalino, D. D., Curry, N. S., Israel, G. M., Jafri, S. Z. H., Kawashima, A., Papanicolaou, N., Remer, E. M., Sandler, C. M., Spring, D. B., & Fulgham, P. (2007).Expert panel on urologic imaging: 14 American college of radiology ACR appropriateness criteria acute onset flank pain—suspicion of stone disease Date of origin: 1995 Last review date: 2007.

    Google Scholar 

  • Cancer risks and radiation exposure from computed tomographic scans how can we be sure that the benefits outweigh the risks? (2009). (Reprinted) Archives of Internal Medicine, 169(22), 2049. December 14/28 www.archinternmed.com American Medical Association. All rights reserved. Downloaded from www.archinternmed.com on December 17, 2009.

  • de Gonza′ lez, A. B., Mahesh, M., Kim, K. –P., Bhargavan, M., Lewis, R., Mettler, F., & Land, C. (2009). Projected cancer risks from computed tomographic scans performed in the united states in 2007 Internal Medicine, 169(22), 2071–2079 www.archinternmed.com.

  • Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: Diagnostic accuracy study, BMJ 2009;339:b2431 doi:10.1136/bmj.b2431.

  • Institute for Clinical Systems Improvement (2009). Pulmonary Embolism (PE) diagnosis algorithm (9th ed.).

    Google Scholar 

  • Katz, S. I., Saluja, S., Brink, J. A., & Forman, H. P. (2006). Genitourinary imaging. Original research radiation dose associated with unenhanced CT for suspected renal colic: Impact of repetitive studies. AJR, 186, 1120–1124. 0361–803X/06/1864–1120 (American Roentgen Ray Society).

    Google Scholar 

  • Kirsch, T. D., Hsieh, Y. -H., Horana, L., Holtzclaw, S. G., Silverman, M., & Chanmugam, A. (2010). Computed tomography scan utilization in emergency departments: A multi-state analysis. The Journal of Emergency Medicine, 7, 771–779

    Google Scholar 

  • Marchione, M., (2010). CT scans pose a growing danger to Americans. Experts call for increased regulation to improve safety, (Associated Press).

    Google Scholar 

  • Medical Liability Monitor (2008). Rate survey. Published in the January 5, 2009 issue of American medical news www.amednews.com.

  • Mettler, F. A., Huda, W., Yoshizumi, T. T., Mahesh, M. (2008). Effective doses in radiology and diagnostic nuclear medicine: A catalog Radiology. 248(1), 254–263

    Google Scholar 

  • Smith-Bindman R. (2012). Environmental causes of breast cancer and radiation from medical imaging: findings from the institute of medicine report. Archives of Internal Medicine. 172(13), 1023–1027

    Google Scholar 

  • Stoker, J., van Randen, A., Lame′ris, W., & Boermeester, M. A. (2009). Imaging patients with acute abdominal pain. Radiology, 253(1), 31–46 Radiology.rsna.org).

    Google Scholar 

  • http://www.fda.gov/RadiationEmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/MedicalX-Rays/ucm115317.htm.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sandra L. Furterer .

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Furterer, S.L. (2014). Appropriate Use of CT Scan in the Emergency Department. In: Lean Six Sigma Case Studies in the Healthcare Enterprise. Springer, London. https://doi.org/10.1007/978-1-4471-5583-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5583-6_7

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5582-9

  • Online ISBN: 978-1-4471-5583-6

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics