Like all medical procedures, diagnostic, therapeutic and interventional radiology and imaging services are provided in a complex environment that demands technical excellence; highly skilled, well trained clinicians and ancillary staff; complicated and costly equipment, and have the potential for serious harm. These services include medical X-Rays, computed tomography (CT), fluoroscopy, mammography, ultrasound imaging, nuclear medicine imaging exams, and radiation therapy treatment.
Increasing attention is being focused on these radiography-related medical services because of recent patient safety incidents of harm and deaths, rapid increases in new technology, dramatic increase in use, increasing regulatory demands, and changes in reimbursement.
These procedures have provided tremendous benefits and improvements in the diagnosis and treatment of medical conditions. However, at the same time, there is a great potential for medical errors and harm of the patient and healthcare provider. Examples of reported events causing harm or death to patients include medication errors, mislabeled images leading to misdiagnoses or attributed to the wrong patient, communication errors leading to omission of serious reported findings, infection risks from breaks in aseptic injection techniques, contrast material-induced nephropathy, radiation overdoses and underdoses, patient harm from incompatibility with implantable devices, and failure to appropriately reduce radiation doses for children. In addition, both patients and workers may be over exposed to ionizing radiation which may elevate their lifetime risk of developing cancer. In 2006, Americans were exposed to more than seven times as much ionizing radiation from medical procedures compared to the early 1980’s, according to a report on population exposure from the National Council on Radiation Protection and Measurements (NCRP), an organization chartered by the U.S. Congress more than 40 years ago. The increase was due mostly to the higher utilization of computed tomography (CT) and nuclear medicine that combined, contributed 75 percent of the medical radiation exposure of the U.S. population (NCRP Report No. 160.).
The challenge is to ensure a balanced approach to the safe use of radiology services that supports both the benefits while minimizing the risk to patients, workers, and public health. Guidance documents, sample policies, safety initiatives, and regulations to enhance safe use of these services have been developed by numerous local, state, federal and international organizations, as well as, private sector and healthcare organizations.
This Web site provides selected resources and sample policies developed to enhance the safety of patients and workers and protect them from harm.
- Denham CR, Swensen SJ, Henderson JM, Goud A, Seltzer SE, Khorasani R. “The Five Rights of Imaging: Patient Centered Performance.” Journal of Patient Safety, Volume 9, 2013.
- Duncan JR, Gibson R. “Safe and Appropriate Medical Imaging: A Call for a National Strategy.” Journal of Patient Safety, Volume 9, 2013.
- Duncan JR, Starr M., Bosma J, Hutson J, “Use in Medical Imaging: Developing a Systematic and Patient-Centered Approach.” Journal of Patient Safety, Volume 9, 2013.
- Johnson CD, Krecke KN, Miranda R, Roberts CC, Denham C. “Developing a Radiology Quality and Safety Program: A Primer.” July 2009 RadioGraphics, 29: 951-959.
- Alliance for Radiation Safety in Pediatric Imaging – How to Develop CT Protocols for Children
- LSU Health Shreveport – Radiation Safety in Pediatric Imaging
- Harvard University Department of Environmental Health and Safety – X-Ray Policy Manual
- University of California, San Francisco –