Using Evidence-Based Criteria to Decrease CT Utilization for Liver Imaging.

Area of Science:

• Radiology
• Medical Imaging
• Quality Improvement

Background:

• Overutilization of radiology imaging, including abdomen and abdominopelvic computed tomography (CT), increases healthcare costs without improving patient outcomes.
• The Centers for Medicare and Medicaid Services identified overuse of CT scans with and without intravenous (IV) contrast at our institution.

Purpose of the Study:

• To implement a quality improvement (QI) initiative aimed at reducing the utilization of abdomen CT scans with and without IV contrast.

Main Methods:

• An intervention was implemented from July 2018 to June 2020, focusing on liver imaging.
• Liver imaging protocols were updated to align with Liver Imaging Reporting and Data System (LI-RADS) guidelines.
• Educational sessions were conducted for clinical and radiology teams to review protocol updates. Control charts tracked CT examination numbers pre- and post-intervention.

Main Results:

• The QI effort led to a decrease in the use of abdomen CT with and without IV contrast for liver imaging.
• There was a concurrent increase in the use of abdomen CT with IV contrast only for liver imaging.

Conclusions:

• Combining national quality metrics guidelines with radiology-led interventions, including education and engagement, can effectively reduce the overutilization of CT imaging.
• This approach demonstrates a successful strategy for optimizing imaging resource allocation and potentially lowering healthcare costs.