[Acute abdomen film: is there hope of changing referring patterns?]. / Prescription en urgence d'un abdomen sans préparation: peut-on espérer changer les mauvaises habitudes?

ABSTRACT

An abdomen radiograph (KUB) is frequently requested by ER physicians as part of the inital work-up of patients. However, other imaging studies are now routinely available in the acute setting that may make the KUB an obsolete and unnecessary examination. The first part of this study was to assess the current referral patterns for urgent KUB in our center; the improper referral pattern for KUB in terms of requests for unnecessary exams 48,5% as well as number of technical errors in terms of inadequate radiographic projection for the suspected pathology 47% were recorded. In a second part, the impact of corrective actions at one month, 2 months and 6 months was assessed and we observed a decrease of about 20% of the number of KUB scheduled by the ER physician. Our results confirm that it is possible to teach ER physicians to more appropriately order imaging studies, which should improve patient care and generate savings. Long term correction of referral patterns is possible if all actors remain involved in this process.