Introducing a Primary Survey Report for Trauma CT Scans

Background and problem

The Royal College of Radiologists advise that trauma CT reports should include a primary survey, to identify and communicate the most immediately life-threatening injuries, so that these injuries can be promptly managed by the trauma team.

In the Radiology department at Gloucestershire Royal Hospital, trauma CTs are reported by local radiologists during normal working hours, though there is no primary survey proforma available to use. This quality improvement project introduced an electronic primary survey proforma.

Aim

50% of trauma CTs reported by local radiologists to include a primary survey by April 2018.

Method

Data was collected retrospectively for October 2017 – March 2018. The October data gave a baseline indication of current practice, the subsequent months followed the introduction of the primary survey proforma. Trauma CT scans performed during these months were extracted using the statistics package of the local CRIS (Computerised Radiology Information System). A search term of “trauma” was used to identify the relevant studies. Each CT scan was analysed as to whether it was performed in hours by a local radiologist, and for the presence or absence of a primary survey.

Results

Following the introduction of the proforma, overall there was an increase in the percentage of locally-reported trauma CT scans including a primary survey over 6 months: from 0% to 40%. Discussion in the monthly departmental meeting proved a more effective intervention than sending reminder emails.

Implications

In order to reach the 50% target, there needs to be further promotion of the primary survey proforma in the Radiology department, incorporating regular reminders and feedback, to encourage engagement of local radiologists. Following this, the eventual objective is to include a primary survey report for all trauma CTs, to ensure every trauma patient benefits from the timely communication of serious injuries.