SHM Converge Scientific Abstract ePoster Gallery-Imaging Wisely Campaign: Reducing Inappropriate Low Back Pain Imaging

Pdf Summary

This quality improvement project aimed to reduce inappropriate imaging for low back pain using an electronic medical record clinical decision support tool. It focused on lumbar CT, MRI, and radiography orders within New York City Health + Hospitals, the largest public hospital system in the U.S., covering 11 acute care hospitals.<br /><br />The background notes that nearly 80% of adults experience nonspecific low back pain during their lifetime, and imaging is generally not recommended unless concerning features are present, because it can lead to unnecessary downstream harm. The intervention was designed to encourage more appropriate imaging use across both inpatient and outpatient settings.<br /><br />Results showed that the intervention successfully decreased lumbar imaging ordering rates in both emergency department and inpatient contexts. Across the targeted modalities, post-intervention averages were lower than pre-intervention averages, with statistically significant reductions reported for multiple order types. The reductions ranged from modest to substantial, including decreases of 9%, 12%, 15%, 23%, 34%, and 42%, depending on modality and setting.<br /><br />The authors conclude that the intervention was effective at reducing lumbar imaging across diverse facilities and settings, and that relying primarily on clinical decision support made the approach resource-efficient and potentially sustainable. They suggest it could be adapted broadly to other healthcare settings.

Asset Subtitle

Mariely Garcia

Meta Tag

Author List Daniel Alaiev, Harry J. Cho, Joseph Talledo, Komal Chandra, Mariely Garcia, Milana Zaurova, Mona Krouss, Peter Alarcon Manchego, Surafel Tsega

Category Innovations

Concept Nonspecific Low Back Pain

Concept Diagnostic Imaging

Concept Lumbar Imaging

Concept Red Flag

Concept Clinical Decision Support

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai

Presenting Author Mariely Garcia

Track Value in Hospital Medicine

Keywords

low back pain

lumbar imaging

clinical decision support

electronic medical record

quality improvement

CT scan

MRI

radiography

inappropriate imaging

New York City Health + Hospitals

Nonspecific Low Back Pain

Diagnostic Imaging

Lumbar Imaging

Red Flag

Clinical Decision Support