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Thematic saturation was achieved after 13 interviews. We identified four factors that distinguish high-performing from low-performing hospitals (1) consistent availability of resources such as ultrasound technicians, pediatric radiologists, and magnetic resonance imaging (MRI); (2) presence of and adherence to protocols guiding imaging modality decision making and imaging execution; (3) culture of inter-departmental collaboration; and (4) presence of a radiation reduction champion. Significant barriers to reducing the use of CT in pediat
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