{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:15:26Z","timestamp":1788437726837,"version":"build-2803163510"},"reference-count":15,"publisher":"IMR Press","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background:Whole-body computed tomography (WBCT) is central to major trauma assessment, but appropriate justification and reporting depend on adequate clinical information at the time of request. The Royal College of Radiologists (RCR) 2024 major trauma guidance recommends six minimum data elements for trauma WBCT requests. This quality improvement project aimed to improve documentation compliance and reduce inappropriate WBCT requests at a district general hospital.Methods:A completed audit cycle was undertaken. Consecutive adult trauma patients undergoing WBCT were identified in a baseline audit (Cycle 1; n = 100, September\u2013December 2024) and a post-intervention re-audit (Cycle 2; n = 100, September\u2013December 2025). Three interventions were introduced: educational feedback to Department of Radiology and Department of Emergency Medicine staff, an RCR-derived electronic request proforma embedded within CareFlow Electronic Patient Record (EPR), and real-time radiologist feedback. Primary outcomes were compliance with the six RCR minimum dataset standards and the proportion of requests meeting RCR WBCT criteria.Results:Baseline compliance varied across documentation domains. In Cycle 1, documentation rates were 74% for mechanism of injury, 94% for primary survey findings, 7% for haemodynamic status, 5% for preceding investigations, 13% for past medical history, and 0% for trauma team leader contact details. Following intervention, mechanism documentation improved to 100% (p &lt; 0.001), haemodynamic status to 93% (p &lt; 0.001), and trauma team leader contact details to 92% (p &lt; 0.001). Primary survey documentation remained high at 97% (p = 0.306). Past medical history increased to 18% (p = 0.329), while preceding investigations remained low at 4% (p = 1.000). Requests meeting RCR WBCT criteria increased from 57% to 96% (p &lt; 0.001), while non-compliant requests fell from 43% to 4%. This represented 39 potentially avoidable scans and approximately 780 mSv of theoretically avoided radiation exposure per 100 requests.Conclusion:A theory-informed intervention combining education, a mandatory electronic proforma, and real-time radiologist feedback substantially improved trauma WBCT request documentation and reduced inappropriate requests. Embedding minimum datasets into electronic requesting systems is a low-cost, scalable strategy to support compliance with the Ionising Radiation (Medical Exposure) Regulations [IR(ME)R] 2017, as amended in 2020, and radiation stewardship.<\/jats:p>","DOI":"10.31083\/bjhm53482","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:29:22Z","timestamp":1788434962000},"source":"Crossref","is-referenced-by-count":0,"title":["Improving Clinical Information on Whole-Body CT Requests for Major Trauma: A Quality Improvement Study"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6563-3704","authenticated-orcid":true,"given":"Rima R","family":"Sansi","sequence":"first","affiliation":[{"name":"Department of Radiology, Kettering General Hospital NHS Foundation Trust, NN16 8UZ Kettering, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6096-1435","authenticated-orcid":true,"given":"Leena","family":"Naidu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kettering General Hospital NHS Foundation Trust, NN16 8UZ Kettering, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0834-4867","authenticated-orcid":true,"given":"Ioan Marius","family":"Ile","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kettering General Hospital NHS Foundation Trust, NN16 8UZ Kettering, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9849-1976","authenticated-orcid":true,"given":"Jatin","family":"Naidu","sequence":"additional","affiliation":[{"name":"University College London Medical School, Faculty of Medical Sciences, University College London, WC1E 6DE London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref1","unstructured":"The Royal College of Radiologists. Major adult trauma radiology guidance. 2024. Available at: https:\/\/www.rcr.ac.uk\/our-services\/all-our-publications\/clinical-radiology-publications\/major-adult-trauma-radiology-guidance\/ (Accessed: 14 June 2026)."},{"key":"ref2","unstructured":"The Royal College of Radiologists. Adequacy of clinical information on multidetector computed tomography requests for adult patients presenting following major trauma. 2025. Available at: https:\/\/www.rcr.ac.uk\/career-development\/audit-quality-improvement\/auditlive-radiology-templates\/adequacy-of-clinical-information-on-multidetector-computed-tomography-mdct-requests-for-adult-patients-presenting-following-major-trauma\/ (Accessed: 14 June 2026)."},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Castillo C, Steffens T, Sim L, Caffery L. The effect of clinical information on radiology reporting: A systematic review. Journal of Medical Radiation Sciences. 2021; 68: 60\u201374.","DOI":"10.1002\/jmrs.424"},{"key":"ref4","unstructured":"The Royal College of Radiologists. IR(ME)R: implications for clinical practice in diagnostic imaging, interventional radiology and diagnostic nuclear medicine. 2020. Available at: https:\/\/www.rcr.ac.uk\/our-services\/all-our-publications\/clinical-radiology-publications\/ir-me-r-implications-for-clinical-practice-in-diagnostic-imaging-interventional-radiology-and-diagnostic-nuclear-medicine\/ (Accessed: 14 June 2026)."},{"key":"ref5","unstructured":"UK Government. Patient dose information: guidance. 2008. Available at: https:\/\/www.gov.uk\/government\/publications\/medical-radiation-patient-doses\/patient-dose-information-guidance (Accessed: 24 April 2026)."},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Knudsen SV, Laursen HVB, Johnsen SP, Bartels PD, Ehlers LH, Mainz J. Can quality improvement improve the quality of care? A systematic review of reported effects and methodological rigor in plan-do-study-act projects. BMC Health Services Research. 2019; 19: 683.","DOI":"10.1186\/s12913-019-4482-6"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science: is. 2011; 6: 42.","DOI":"10.1186\/1748-5908-6-42"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Reason J. Human error: models and management. BMJ (Clinical Research Ed.). 2000; 320: 768\u2013770.","DOI":"10.1136\/bmj.320.7237.768"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Carver CS, Scheier MF. Control theory: a useful conceptual framework for personality-social, clinical, and health psychology. Psychological Bulletin. 1982; 92: 111\u2013135.","DOI":"10.1037\/0033-2909.92.1.111"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Quality & Safety. 2016; 25: 986\u2013992.","DOI":"10.1136\/bmjqs-2015-004411"},{"key":"ref11","unstructured":"Depasquale R, Crockford MP. Are radiology request forms adequately filled in? An audit assessing local practice. Malta Medical Journal. 2005; 17: 36\u201338."},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Rickett AB, Finlay DB, Jagger C. The importance of clinical details when reporting accident and emergency radiographs. Injury. 1992; 23: 458\u2013460.","DOI":"10.1016\/0020-1383(92)90063-x"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Ananthan K, Whitfield JP. The appropriateness of abdominal X-ray requests in the acute medical initial admissions unit. British Journal of Hospital Medicine (London, England: 2005). 2022; 83: 1\u201310.","DOI":"10.12968\/hmed.2021.0603"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Blackmore CC, Mecklenburg RS, Kaplan GS. Effectiveness of clinical decision support in controlling inappropriate imaging. Journal of the American College of Radiology: JACR. 2011; 8: 19\u201325.","DOI":"10.1016\/j.jacr.2010.07.009"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Dunne CL, Elzinga JL, Vorobeichik A, Sudershan S, Keto-Lambert D, Lang E, et al. A Systematic Review of Interventions to Reduce Computed Tomography Usage in the Emergency Department. Annals of Emergency Medicine. 2022; 80: 548\u2013560.","DOI":"10.1016\/j.annemergmed.2022.06.001"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/8\/10.31083\/BJHM53482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:30:06Z","timestamp":1788435006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/8\/10.31083\/BJHM53482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)03441-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm53482","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"article-number":"53482"}}