News | March 19, 2012

Preventing ‘Wrong’ Events in Radiology

March 19, 2012 - Radisphere announced availability of its next “Quality Update” piece as part of its “The Final Read on Quality” initiative. In the piece titled “Preventing Wrong Events in Radiology,” now available at www.radisphere.net/ FinalReadonQuality, the case is made for utilizing the universal protocol in radiology to help prevent errors.

The Joint Commission has stated that correct patient identification is critical to patient safety and established “accurate patient identification” as its first National Patient Safety Goal in 2003. It required implementation of the Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surger in 2004. Originally developed to prevent errors in surgery, the Universal Protocol is useful in other areas, including radiology.

Why errors in radiology occur

Since radiology orders are often entered by administrative personnel, there can be a higher incidence of wrong events. These can include scheduling errors, scanning errors or inappropriate use of contrast agents. Communication problems with patients and technologists (e.g., dementia or cognitive problems, illegible handwriting or language barriers) also can increase error risks.

Below are three scenarios that illustrate these issues in detail:

1. A referring physician intended to order an MRI of a patient’s right knee, but the clerk entering the order accidentally selected the left knee. Because the technologist did not compare the order to the patient’s history, the wrong examination was performed.

2. Transport personnel relied only on a room number when taking a patient to radiology for a CT scan. Since the correct patient had been transferred out of the room, the new, non-communicative occupant was mistakenly transported. The technologist, who was behind schedule, hurriedly performed the examination on the wrong patient, never detecting the error. The negative test results were placed in the
record of the correct patient, preventing accurate diagnosis of a life-threatening pulmonary embolism.

3. An outpatient, who arrives for a CT scan, is given contrast agent during the procedure, even though they had disclosed a history of contrast allergy to the technologist. The patient suffers a serious allergic reaction that can be life-threatening. As a result, the patient requires an unplanned admission to the hospital.

“Regardless of the medical specialty or setting, specific training is required to prevent wrong events,” said Radisphere’s co-founder and Chief Medical Officer Frank Seidelmann, D.O. “Our Quality Management department works with hospital safety leaders to identify and mitigate risks associated with wrong events in radiology. The objective is to provide clients with support on important drivers of patient safety and performance improvement that can reduce errors over time.”

The aim of “The Final Read on Quality” initiative is to help hospitals improve patient care and radiology performance through ongoing quality efforts.

Radisphere works with rural and community hospitals to measurably improve quality and patient care, while managing costs. The company helps raise the levels of radiology services accountability, performance and satisfaction at hospitals.

For more information: www.radisphere.net

Related Content

American College of Radiology Releases New Patient-Oriented Appropriateness Criteria Summaries
News | Patient Engagement | January 19, 2018
January 19, 2018 — New Appropriateness Criteria (AC) Patient Summaries from the American College of Radiology (ACR) c
National Clinical Decision Support Company (NDSC) has an exclusive deal with the American College of Radiology (ACR) to provide medical imaging appropriate use criteria (AUC).

National Clinical Decision Support Company (NDSC) has an exclusive deal with the American College of Radiology (ACR) to provide medical imaging appropriate use criteria (AUC). 

Feature | Clinical Decision Support | January 18, 2018
January 18, 2018 — Change Healthcare announced the acquisition of National Decision Support Company (NDSC), a leader
Videos | Artificial Intelligence | January 18, 2018
ITN Contributing Editor Greg Freiherr offers an overview of artificial intelligence advances at the Radiological Soci
Philips Introduces Technology Maximizer Program for Imaging Equipment Upgrades
Technology | Imaging | January 17, 2018
January 17, 2018 — Philips recently announced the launch of Technology Maximizer, a cross-modality program designed t
Sponsored Content | Videos | Enterprise Imaging | January 17, 2018
Mitchell Goldburgh, global solutions manager for enterprise imaging and analytics manager for NTT Data Services, form
Sponsored Content | Videos | Enterprise Imaging | January 16, 2018
Built on an over 25-year pioneering legacy in the advanced visualization industry, Vital continues to expand on three
RSNA 2017 Celebrates Innovation in Radiology
News | Imaging | January 15, 2018
January 15, 2018 — The Radiological Society of North America’s...
News | Clinical Decision Support | January 12, 2018
January 12, 2018 — GE Healthcare has entered into a strategic, long-term partnership with Roche to jointly develop an

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
RSNA 2017 technical exhibits, expo floor, showing new radiology technology advances.
Feature | RSNA 2017 | January 11, 2018
January 11, 2018 — Here is a list of some of the key clinical study presentations, articles on trends and videos from
Overlay Init