Researchers from Mount Sinai Beth Israel in New York found that a restrictive approach to ordering chest x-rays (CXRs) produced positive outcomes. The research team, who recommended the restrictive approach instead of ordering them routinely, created a quality improvement initiative in 2012. The team hypothesized that the restrictive approach would considerably reduce a patient’s exposure to radiation and reduce ICU operating costs without adversely affecting patient outcomes.

The restrictive approach to ordering CXRs was implemented at a teaching hospital in January 2012, and subsequently a retrospective review was conducted of all ICU patients from 2011 to 2014 to examine effectiveness. The results of the study found that a restrictive approach led to large decreases in total CXRs ordered, correcting for both total number of patients and ventilator days, according to an American College of Chest Physicians news release.

The results also showed that there was no negative impact on the total number of patient ventilator days, length of stay, and other outcomes.

Jason Filopei, MD, lead research of the study and physician at Mount Sinai Beth Israel, states, “A restrictive approach to ordering chest x-rays in the ICU appears to be a safe practice. We believe it will lead to a significant saving of hospital resources.”

Source: American College of Chest Physicians