Federal organizations and healthcare providers are growing increasingly concerned about the harmful effects of cumulative radiation doses. In August, The Joint Commission released a Sentinel Event Alert on the risk to patients of repeated diagnostic radiation doses. In response, hospitals and other healthcare organizations are seeking ways to reduce the risk and improve patient safety.
Radisphere launched "The Final Read on Quality" initiative in October to help community hospitals improve the quality and safety of their radiology services. The initiative will focus first on reducing radiation dosage for patients and will then address the implementation of the Universal Protocol and the prevention of acute renal injury after contrast testing.
Dose reduction
"We have an opportunity to better manage radiation dose through collaboration between radiologists and hospitals, as well as through modifying the parameters of the [radiation] test itself," says Teri Yates, CHC, chief compliance officer and director of quality management at Radisphere. "Unfortunately, many radiology groups don't have the dedicated resources to work on quality projects — their clinicians are busy reading cases and taking care of patients. That's the gap that we want to fill," she says.
One example is helping to educate radiologic technologists about how they can change the technical factors of the test to directly reduce the dose. In addition, focusing as tightly as possible on the specific area that needs to be scanned and decreasing the number of sequences and phases of the scan can lower the dose, according to Ms. Yates. Many scanners have standard protocols, so changing the parameters would require an extra step. But educating the care provider on the different options when scanning can encourage them to take this extra step to improve patient safety, she says.
Deciding when and how to change the parameters of a test may depend on the particular patient. "You have to approach it as 'one size does not fit all,'" Ms. Yates says. For instance, smaller patients require less radiation exposure to create images than larger patients, and older patients' tissues are less sensitive to the effects of radiation compared to younger patients, according to Ms. Yates. "You have to train and educate technologists on these differences."
The "one size does not fit all" philosophy also applies to strategies implemented at different hospitals because they each have different strengths and weaknesses in radiology. "It's important to assess for each hospital what is needed and what [its] current state is," Ms. Yates says. For example, she says some hospitals have new CT scanners that include dose reduction software that can help technicians lower the dose more easily. Even with quality technology, some hospitals may need a better plan for communicating the risk of radiation to patients.
Education
Ms. Yates suggests "educating other people involved with patients' care on non-radiation-producing alternatives," when determining a method of diagnosis or treatment. Radisphere is implementing new imaging protocols later this month to provide physicians, technicians and other staff with a resource on best practices in imaging. "Education, repetition and honest discussion about the issues" can help people change their behavior, she says. "People generally find it difficult to change quickly, yet it can be easier for them to change if they understand the reasons why and feel that they are part of that change."
Educating healthcare providers on the dangers of cumulative radiation doses can also enable them to educate their patients. "Another part of [the initiative] is helping the hospitals implement other necessary steps that include educating patients or parents of pediatric patients about the risks involved with radiation so they can advocate for themselves," Ms. Yates says.
Future
The Final Read on Quality initiative is planned to run through 2012 and will address several radiology-related quality and safety issues. The initiative aims to benefit not only the patient, but also the provider in staying compliant with regulations and avoiding penalties. For example, not screening patients properly can result in acute renal injury after contrasts, which CMS is considering including as a non-reimbursable hospital-acquired condition, according to a Radisphere news release.
Learn more about Radisphere.
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Radisphere launched "The Final Read on Quality" initiative in October to help community hospitals improve the quality and safety of their radiology services. The initiative will focus first on reducing radiation dosage for patients and will then address the implementation of the Universal Protocol and the prevention of acute renal injury after contrast testing.
Dose reduction
"We have an opportunity to better manage radiation dose through collaboration between radiologists and hospitals, as well as through modifying the parameters of the [radiation] test itself," says Teri Yates, CHC, chief compliance officer and director of quality management at Radisphere. "Unfortunately, many radiology groups don't have the dedicated resources to work on quality projects — their clinicians are busy reading cases and taking care of patients. That's the gap that we want to fill," she says.
One example is helping to educate radiologic technologists about how they can change the technical factors of the test to directly reduce the dose. In addition, focusing as tightly as possible on the specific area that needs to be scanned and decreasing the number of sequences and phases of the scan can lower the dose, according to Ms. Yates. Many scanners have standard protocols, so changing the parameters would require an extra step. But educating the care provider on the different options when scanning can encourage them to take this extra step to improve patient safety, she says.
Deciding when and how to change the parameters of a test may depend on the particular patient. "You have to approach it as 'one size does not fit all,'" Ms. Yates says. For instance, smaller patients require less radiation exposure to create images than larger patients, and older patients' tissues are less sensitive to the effects of radiation compared to younger patients, according to Ms. Yates. "You have to train and educate technologists on these differences."
The "one size does not fit all" philosophy also applies to strategies implemented at different hospitals because they each have different strengths and weaknesses in radiology. "It's important to assess for each hospital what is needed and what [its] current state is," Ms. Yates says. For example, she says some hospitals have new CT scanners that include dose reduction software that can help technicians lower the dose more easily. Even with quality technology, some hospitals may need a better plan for communicating the risk of radiation to patients.
Education
Ms. Yates suggests "educating other people involved with patients' care on non-radiation-producing alternatives," when determining a method of diagnosis or treatment. Radisphere is implementing new imaging protocols later this month to provide physicians, technicians and other staff with a resource on best practices in imaging. "Education, repetition and honest discussion about the issues" can help people change their behavior, she says. "People generally find it difficult to change quickly, yet it can be easier for them to change if they understand the reasons why and feel that they are part of that change."
Educating healthcare providers on the dangers of cumulative radiation doses can also enable them to educate their patients. "Another part of [the initiative] is helping the hospitals implement other necessary steps that include educating patients or parents of pediatric patients about the risks involved with radiation so they can advocate for themselves," Ms. Yates says.
Future
The Final Read on Quality initiative is planned to run through 2012 and will address several radiology-related quality and safety issues. The initiative aims to benefit not only the patient, but also the provider in staying compliant with regulations and avoiding penalties. For example, not screening patients properly can result in acute renal injury after contrasts, which CMS is considering including as a non-reimbursable hospital-acquired condition, according to a Radisphere news release.
Learn more about Radisphere.
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