MEDIC: Shared Decision Making Tool for Minor Traumatic Brain Injuries
Despite the minimal risk of serious neurologic sequela after a minor traumatic brain injuries (TBI), minor TBIs are often inappropriately imaged. This increases radiation exposure, cost, and wait times for the patient.
In conjunction with the Michigan Emergency Department Improvement Collaborative (MEDIC), a state-wide initiative to improve delivery of emergency care, the University of Michigan formed a task force to address challenges in their emergency department. Together, we identified that the inappropriate number of head computer tomography (CT) imaging ordered for TBIs was due to poor understanding of the Canadian Head CT rule as well as pressure from fearful patients.
As a team, we created reminders in the Epic electronic medical record that flag with ordering and this shared decision making tool to help educate our patients. Prospective data is being collected to evaluate these interventions. Primary outcome is a reduction in inappropriate head CT ordered for minor head injuries.