BackgroundLumbosacral spine (LS) X-rays are essential diagnostic tools in orthopaedic and spinal practice, aiding in the evaluation of conditions such as trauma, degenerative diseases, infections, and deformities. However, inadequate imaging can lead to diagnostic uncertainty, repeat radiographs, increased radiation exposure, delayed clinical decision-making, and unnecessary healthcare costs. This audit aimed to assess the adequacy of LS spine X-rays ordered by the Orthopaedics Department in a tertiary hospital, identify factors contributing to poor-quality imaging, and implement interventions to reduce re-exposure rates.AimThis study aimed to improve adequacy rates of Orthopaedic lumbosacral spine X-rays and decrease re-exposure rates.MethodsThis was a three-phase observational audit conducted over 1 year at a tertiary hospital, evaluating all lumbosacral spine X-rays ordered by the Orthopaedics Department. Each phase lasted three months, followed by stakeholder meetings to review findings and implement interventions. Image adequacy was assessed using predefined radiographic criteria based on international guidelines. Interventions included radiographer training, standardized imaging protocols, and a quality control checklist. The primary outcome was the proportion of adequate X-rays, while the secondary outcome was the re-exposure rate. Data were analysed using descriptive statistics (percentage change) to assess improvements across phases.ResultsThe adequacy of image improved significantly from 82.5% at the first phase to 95.1% in the final phase, and re-exposure rates dropped from 3.125% to 0%.Keywords: Lumbosacral spine, Radiograph adequacy, Clinical audit, Re-exposure, Quality improvement
Data available on reasonable request from the corresponding author.
None declared.
Suman K. Basel: Conceptualization and design, Acquisition and analysis of data, Manuscript drafting and review Pramod Bhandari: Acquisition and analysis of data, Manuscript drafting and review Gaurav Bir Bajracharya: Acquisition and analysis of data, Manuscript drafting and review Shriraj Shrestha: Conceptualization and design, Supervision
No funding was received for this audit.
SPSS v16.
We would like to express our sincere gratitude to the Department of Radiology for their valuable cooperation and support throughout this audit. Their commitment to quality improvement and active participation in training, protocol development, and feedback discussions were instrumental in achieving the outcomes of this study.
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