Reducing neuroimaging in first-episode psychosis by facilitating uptake of choosing wisely recommendations: a quality improvement initiative

[摘要] First-episode psychosis (FEP) is a frequentpresentation to hospital.1 Neuroimagingis often ordered during the initial assessment to facilitate diagnostic buy-in, mitigatemedico-legal concerns, and maximise assessment in a patient population that is typicallymarginalised.2 3 These benefits, however, areoutweighed by the unnecessary radiation,cost, and strong evidence that neuroimagingrarely yields actionable findings.2 3 This stanceis evidenced in international guidelines2 3and Choosing Wisely Canada (CWC) recommendations.4Our site’s radiology department queriedinconsistent (per guidelines) CT imaging inFEP, given requisition patterns. We undertook a quality improvement initiative to determine the prevalence of inconsistent imagingand study the effectiveness of an intervention aimed at improving recommendationadherence.

[学科分类] 药学

[关键词] healthcare quality improvement;diagnostic services;emergency department;evidence-based medicine;unnecessary procedures