title: Improving trauma imaging in Wales through Kotter's theory of change.
abstract: OBJECTIVE
  To improve the practice of trauma computed tomography (CT) within Wales using recognised leadership techniques for change.
  
  
  METHODS
  Royal College of Radiologists' (RCR) guidance, in addition to other key recent evidence, were used to form an aspirational standard. All centres across Wales with a major emergency department were included. Kotter's theory of change was utilised to facilitate an improvement in practice across the region, with larger units prioritised initially.
  
  
  RESULTS
  Of the 13 major emergency units in Wales, eight centres had no formal trauma CT protocol. Only one centre utilised the Bastion protocol (in comparison to 75% of major trauma centres). After the campaign to improve trauma imaging, seven centres now offer the Bastion protocol, with currently only three peripheral centres still without a procedure for whole-body CT. The two largest centres have implemented an emergency department pro forma.
  
  
  CONCLUSIONS
  Trauma CT within Wales has significantly improved as a result of this project. Kotter's theory is demonstrated as an effective tool for facilitating a change in practice on a regional/national scale.
authors.affiliation: Royal Gwent Hospital, Newport NP20 2UB, UK. Electronic address: dfwmaclean@doctors.org.uk.
authors.forename: D F W
authors.initials: DF
authors.lastname: Maclean
authors.affiliation: Royal Gwent Hospital, Newport NP20 2UB, UK.
authors.forename: N
authors.initials: N
authors.lastname: Vannet
mesh_terms: D004632:Emergency Medical Services; D005544:Forecasting; D006801:Humans; D007407:Interviews as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards / Q000639:trends; D014852:Wales; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*