Effectiveness of a radiation reduction campaign targeting children with gastrointestinal symptoms in a pediatric emergency department.

Abstract

Children feature more active cellular division and a smaller body area, which leads to a greater radiation dosage accumulation. We tried to reduce radiation hazards by reducing unnecessary radiological studies in a pediatric emergency department (PED) through the radiation reduction campaign.Our campaign involved a reduction from 2 (erect and supine) to 1 ordered abdominal plain radiograph (erect). This quasi-experimental, uncontrolled before-and-after study aimed to evaluate the campaign effect. We compared simple radiograph orders, length of stay (LOS) in PED, and return visit (RV) to PED between the before period (June 1, 2011–May 30, 2014) and the after period (June 1, 2014–May 30, 2015). Piecewise regression was used to assess rate differences between the periods.A total of 10,729 and 3515 patients were included before and after the campaign, respectively. During study periods, 9647 (90%) and 2710 (77%) total abdominal radiographs were ordered, respectively (rate difference = 13%; P < 0.001), and the slopes of rate changes were 0.03 and −0.71, respectively (P = 0.056). The total abdominal erect and supine film rate slope decreased from −0.19 to −2.86 (P = 0.004). The RV rate did not change (220 [2%] vs 56 [2%], respectively; P = 0.104). The slope of total RV rate changed from −0.01 to −0.05 (P = 0.132), and the slope of LOS changed from 0.001 to −0.352 (P = 0.243).The campaign to reduce abdominal radiograph orders in pediatric patients successfully reduced the abdominal plain film X-ray rate without on the RV rate and the LOS.