title: Short- and long-term effects of clinical audits on compliance with procedures in CT scanning.
abstract: OBJECTIVE
  To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning.
  
  
  METHODS
  This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific "paediatric brain CT" procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test.
  
  
  RESULTS
  Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from <0.001 to 0.031) in both hospitals and remained unchanged during the third audit (P ranging from 0.114 to 0.999).
  
  
  CONCLUSIONS
  Quality improvement through repeated compliance audits with CT procedures durably improves this compliance.
  
  
  CONCLUSIONS
  • Compliance with CT procedures is operator-dependent and not perfect. • Compliance differs between procedures and hospitals, even within a unified department. • Compliance is improved through audits followed by communication to the stakeholders. • This improvement is sustainable over a one-year period.
authors.affiliation: Université libre de Bruxelles, School of Medicine, Route de Lennik 808, 1070, Brussels, Belgium.
authors.forename: Antonio
authors.initials: A
authors.lastname: Oliveri
authors.affiliation: Department of Radiology, Clinique des Grangettes, 7 Chemin des Grangettes, 1224, Chêne-Bougeries, Switzerland.
authors.forename: Nigel
authors.initials: N
authors.lastname: Howarth
authors.affiliation: Department of Radiology, Hôpital Erasme, Route de Lennik 808, 1070, Brussels, Belgium.
authors.forename: Pierre Alain
authors.initials: PA
authors.lastname: Gevenois
authors.affiliation: Department of Radiology, EpiCURA, Clinique Louis Caty, rue Louis Caty 136, 7331, Baudour, Belgium. denis.tack@skynet.be.
authors.forename: Denis
authors.identifier: http://orcid.org/0000-0002-1509-1983
authors.initials: D
authors.lastname: Tack
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D054869:Clinical Audit; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D012189:Retrospective Studies; D013995:Time; D014057:Tomography, X-Ray Computed / Q000592:standards*
keywords: Adults and Paediatrics; Audits; Computed tomography; Quality Assurance; Radiation dose