Posters for accident departments: simple method of sustaining reduction in x ray examinations.

OBJECTIVE--To assess whether a simple strategy would sustain a reduction in the number of unnecessary x ray examinations. DESIGN--Use of posters to display guidelines encouraging the more effective use of radiology in patients with head injuries, twisted ankles, neck injuries, and abdominal pain. SETTING--Accident department of a large metropolitan district general hospital. PATIENTS--15,875 patients attending the accident department over two years. MAIN OUTCOME MEASURE--Proportion of patients having radiography. RESULTS--Referrals for skull radiography fell from 56% to 20% and those for abdominal radiography fell from 31% to 7%. Referral patterns for adults attending with twisted ankles and cervical spine injuries did not change. Reductions were sustained over two years. CONCLUSION--Carefully designed posters provide a simple method of reducing unnecessary x ray examinations.