Possible impact of audit on chest X-ray requests from surgical wards

Use of chest X-rays in the surgical wards of two district general hospitals was monitored from 1976 to 1980. Utilisation fell by 42% in one hospital and by 26% in the other. There was no evidence that substantial reduction in the use of chest X-rays was associated with increased postoperative morbidity (as reflected in postoperative length of stay) or mortality. Indeed in one hospital there was a significant fall in postoperative length of stay and postoperative mortality during the study period. It is likely that publicity given to the overuse of preoperative chest X-rays and to the guidelines for more effective use which subsequently emerged has played an important part in bringing about the observed reduction in use of this investigation.