The project I worked on was called ‘A Rational Approach to Ordering Peripheral Limb CT’s in and Emergency Department’. I worked with the No Unnecessary Tests (NUT’s) Initiative through Eastern Health’s Emergency Department. We found that peripheral CT’s performed in an Emergency Department (ED) are often unnecessary and rarely time critical. They are commonly used to confirm an inconclusive x-ray or as part of a pre-theatre workup. They result in unnecessary queuing of the ED CT machine, require expert interpretation and can delay patient discharge by many hours.Currently there are no precise guidelines for peripheral CT’s ordered in ED for potential limb fractures. RAP CT (Rational Approach to ordering Peripheral CT’s) is a rational ordering tool developed collaboratively by our ED and orthopaedic unit and aims to decrease the number of peripheral CT’s performed in ED. Retrospective application of RAP CT to 124 patients across Eastern Health ED’s shows a potential 78% decrease in CT’s ordered and performed in ED. As for next steps, we plan on conducting a prospective study once RAP CT is implemented in our ED’s to assess the real world applicability of this tool, as well as to monitor patient safety and satisfaction.
This poster was presented at NPS Choosing Wisely Conference in May 2017 after submitting an abstract. I was awarded ‘Best Medical Student Abstract’, and this was presented by Professor Brendan Murphy, Chief Medical Officer for the Australian Government. It was an enjoyable conference and a great privilege to receive this award. I look forward to continuing research into this area.