COMPUTED-TOMOGRAPHY IMAGING IN CHILDREN WITH HEAD TRAUMA - UTILIZATION AND APPROPRIATENESS FROM A QUALITY IMPROVEMENT PERSPECTIVE

Computed tomography (CT) imaging plays an important role in the acute evaluation and management of children with head trauma. When routine q uality improvement (QI) meetings with representatives from the Childre n's Hospital radiology and emergency departments revealed disagreement regarding the utilization and appropriateness of CT in children prese nting with head trauma, an interdepartmental Ql team was formed to add ress this issue. Because formal criteria for obtaining CTs for head tr auma were unavailable, internal institutional criteria were developed by consensus after literature review. Contrary to perceptions of some staff members, the majority (95%) of children who received CT met at l east one of the established criteria over a one-year study period. The re was little relationship between the presence of criteria and abnorm al CT results, but decisions whether to admit patients to the hospital or to send them home were influenced by CT results. Follow-up studies suggested that patients who were discharged home with a normal CT or no CT had uniformly good outcomes.