In the News

Diagnostic Imaging Alert

The Joint Commission issued a Sentinel Event Alert on August 24, 2011, about the radiation risks of diagnostic imaging, stating that, over the past two decades, the total exposure in the population of the United States has nearly doubled (1).

Even though diagnostic radiation can save lives, ionzing x-rays are classified as a known carcinogen. A study done in 2007 estimated 29,000 future cancers and 14,500 future deaths could result from radiation exposure.

While experts disagree on the extent of the risks of cancer from diagnostic imaging, care should be taken to weigh the medical necessity of a given level of radiation exposure against the risks, and steps should be taken to eliminate avoidable exposure (2). The most common diagnostic procedures include CT, nuclear medicine and fluoroscopy. Harm from radiation exposure is most likely to affect:

• Children and young adults
• Pregnant women
• Individuals with diabetes and hyperthyroidism
• Individuals who receive multiple doses over time

The Joint Commission suggests the following actions to reduce the risks associated with avoidable diagnostic radiation by ensuring:

• The right test is ordered
• The right dose is used
• Imaging policies and procedures focus on patient safety
• Equipment is safely monitored
• A Safety Culture is in place at the facility

The Centers for Medicare and Medicaid Services (CMS) recognize the danger associated with ionizing radiation and require accreditation of facilities providing CT, MRI, PET and nuclear medicine servies in non-hospital settings, which became effective January 1, 2012. California is mandating even more rigorous accreditation, including documentation of the dose of each CT scan by July 1, 2013.

Healthcare organizations can reduce the risks of avoidable diagnostic radiation. Avoidable exposure can occur anywhere from the radiology setting in the provider’s office to a hospital radiology department. The Joint Commission suggests increasing the education and awareness of staff, patients and providers to make sure the right tests and dosages are used. Monitoring should be done to ensure locations providing the service have a comprehensive radiation safety program, which is key to reducing avoidable radiation exposure and its long term effects.

The entire Sentinel Event Alert may be accessed at jointcommission.org/sea_issue_47