Performance improvement and patient safety program (PIPS) guided quality improvement initiatives can significantly reduce CT imaging in pediatric trauma patients.

Background: Morbidity and mortality of cervical spine (C-Spine) injury in pediatric trauma patients is high, necessitating quick and accurate diagnosis. Best practices emphasize minimizing radiation exposure through decreased reliance on computed tomography (CT), instead using clinical assessment, physical examination and alternate imaging techniques. We implemented an institutional performance improvement and patient safety program (PIPS) initiative for C-Spine clearance in 2010 due to high rates of CT scans among pediatric trauma patients. Methods: A retrospective review of pediatric trauma patients, ages 0-14, in the pre- and post-PIPS implementation periods was conducted. Rates of C-Spine CT, overall CT, other imaging modalities, radiation exposure, patient characteristics and injury severity were compared, and compliance with PIPS protocol was reviewed. Results: Patient characteristics and injury severity were similar pre- and post-PIPS implementation. C-Spine CT rates decreased significantly between groups (30% v 13%, p

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