Ra­di­a­tion warn­ings

Sen­tinel alert could presage ac­cred­i­ta­tion changes

Modern Healthcare - - The Week - Paul Barr

The Joint Com­mis­sion re­turned the spotlight to pa­tient ra­di­a­tion risks with a Sen­tinel Event Alert on the sub­ject that in­vites the ques­tion of whether re­vised hos­pi­tal ac­cred­i­ta­tion stan­dards may be coming down the line.

The alert is­sued Aug. 24 con­cerns the risks of most types of di­ag­nos­tic ra­di­a­tion imag­ing, but the ac­cred­i­ta­tion and qual­ity group also is tak­ing a look at the risks of ther­a­peu­tic ra­di­a­tion and of the di­ag­nos­tic treat­ment known as flu­o­roscopy, said Paul Schyve, se­nior ad­viser in health­care im­prove­ment for the Oak­brook Ter­race, Ill.-based Joint Com­mis­sion.

The Joint Com­mis­sion de­cided to is­sue the alert based on re­ports it re­ceived from hos­pi­tals, as well as be­cause of me­dia re­ports high­light­ing pa­tients harmed by de­vices used for ra­di­a­tion treat­ment and di­ag­no­sis, Schyve said.

Given the risks and the grow­ing pop­u­lar­ity of CT scans and their ilk, the stakes are great. The alert notes that one study es­ti­mated that 29,000 fu­ture can­cers and 14,500 fu­ture deaths could develop be­cause of ra­di­a­tion from the 72 mil­lion CT scans performed in the U.S. in 2007. A sep­a­rate study in the Nov. 29 is­sue of the jour­nal Ra­di­ol­ogy found the num­ber of an­nual emer­gency room vis­its that in­cluded CT scans in­creased by 500%—from 2.7 mil­lion to 16.2 mil­lion—be­tween 1995 and 2007.

The alert sug­gests or­ga­ni­za­tions do such things as en­sure there is a cul­ture of safety sur­round­ing the use of ra­di­a­tion di­ag­no­sis de­vices, that providers en­sure the right test is be­ing con­ducted given the cir­cum­stance and that providers take steps to en­sure the right dose is be­ing given. Providers of di­ag­nos­tic ra­di­a­tion should con­sider al­ter­na­tives to ra­di­a­tion, such as MRIs; try to use the least ra­di­a­tion pos­si­ble to ac­cu­rately make a di­ag­no­sis; and rely on rec­om­men­da­tions from ex­pert or­ga­ni­za­tions on us­ing ra­di­a­tion de­vices, Schyve said.

Joint Com­mis­sion of­fi­cials con­tinue to study other forms of med­i­cal ra­di­a­tion and haven’t de­cided whether to is­sue a Sen­tinel Event Alert on ther­a­peu­tic ra­di­a­tion or whether to beef up its ac­cred­i­ta­tion stan­dards on the sub­ject of ra­di­a­tion, but both are pos­si­ble, Schyve said.

The Amer­i­can Col­lege of Ra­di­ol­ogy, which ac­cred­its imag­ing fa­cil­i­ties, sup­ports the idea of hos­pi­tals re­quir­ing ac­cred­i­ta­tion for imag­ing, as are non­hos­pi­tal providers, said Amer­i­can Col­lege of Ra­di­ol­ogy spokesman Shawn Far­ley. The col­lege also en­dorsed the Sen­tinel Event Alert’s sup­port for the cre­ation of a na­tional registry to track ra­di­a­tion doses to help cre­ate ref­er­ence and op­ti­mal doses; the col­lege of­fers such a registry cur­rently for a fee, Far­ley said.

Nancy Foster, vice pres­i­dent of qual­ity and pa­tient safety with the Amer­i­can Hos­pi­tal As­so­ci­a­tion, was less en­thu­si­as­tic about adding an­other re­port­ing re­quire­ment and said pa­tient-safety or­ga­ni­za­tions are bet­ter suited to track such things. “We can’t have a registry for ev­ery sin­gle thing that goes on,” she said.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.