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. 2016 May;71(5):427-31.
doi: 10.1016/j.crad.2016.02.003. Epub 2016 Mar 11.

Improving trauma imaging in Wales through Kotter's theory of change

D F W Maclean  1 , N Vannet  2
Affiliations

Improving trauma imaging in Wales through Kotter's theory of change

D F W Maclean et al. Clin Radiol. 2016 May.

Abstract

Aim: To improve the practice of trauma computed tomography (CT) within Wales using recognised leadership techniques for change.

Materials and methods: Royal College of Radiologists' (RCR) guidance, in addition to other key recent evidence, were used to form an aspirational standard. All centres across Wales with a major emergency department were included. Kotter's theory of change was utilised to facilitate an improvement in practice across the region, with larger units prioritised initially.

Results: Of the 13 major emergency units in Wales, eight centres had no formal trauma CT protocol. Only one centre utilised the Bastion protocol (in comparison to 75% of major trauma centres). After the campaign to improve trauma imaging, seven centres now offer the Bastion protocol, with currently only three peripheral centres still without a procedure for whole-body CT. The two largest centres have implemented an emergency department pro forma.

Conclusion: Trauma CT within Wales has significantly improved as a result of this project. Kotter's theory is demonstrated as an effective tool for facilitating a change in practice on a regional/national scale.

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