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Joint Commission Alert: Use diagnostic radiation carefully
9/7/2011
 
A Joint Commission Sentinel Event Alert warns that healthcare organizations must seek new ways to reduce exposure to repeated doses of harmful radiation. The Alert urges greater attention to the risk of long-term damage and cumulative harm.

The Joint Commission notes that over the past two decades, the U.S. population’s total exposure to ionizing radiation has nearly doubled with the increased use of diagnostic imaging in hospitals, imaging centers, and physician and dental offices. Any physician can order radiologic tests at any frequency with no knowledge of when the patient was last irradiated or how much radiation the patient received. Several recent studies have raised concerns about the risk of cancer from diagnostic imaging, especially in vulnerable populations such as children, young adults, and pregnant women.

The specific actions suggested by The Joint Commission include:
  • Use of imaging techniques other than CT, such as ultrasound or magnetic resonance imaging (MRI), and collaboration between radiologists and referring physicians about the appropriate use of diagnostic imaging.

  • Adherence to the Nuclear Regulatory Commission’s ALARA (“as low as reasonably achievable”) guidelines, as well as guidelines from the Society for Pediatric Radiology, American College of Radiology, and Radiological Society of North America for imaging for children and adults, respectively.

  • Assurance by radiologists that the proper dosing protocol is in place for the patient being treated and review of all dosing protocols against the latest evidence either annually or every two years.

  • Expansion of the radiation safety officer’s role to explicitly include patient safety as it relates to radiation and dosing, as well as education on proper dosing and equipment usage for all physicians and technologists who prescribe diagnostic radiation or use diagnostic radiation equipment.

  • Implementation of centralized quality and safety performance monitoring of all diagnostic imaging equipment that may emit high amounts of radiation cumulatively.