Joint Commission Issues Alert on Medical Radiation Dangers

The U.S. Joint Commission clearly has radiology on its radar screen: It has issued an alert on the dangers of medical radiation. In a statement released yesterday, the accreditation agency notes that the U.S. population's exposure to ionizing radiation has nearly doubled in the past two decades. It also decries the ability of any physician to order tests involving radiation exposure at any frequency and with no knowledge of when the patient was last irradiated or how much radiation he or she received. While no event or rationale sparked the action, the Joint Commission acknowledges that “studies assessing medical radiation's risks" rely on “currently unverified scientific assumptions.” However, notes President Mark Chassin, MD, recent studies have raised concerns about imaging overuse, particularly "in vulnerable populations such as children, young adults, and pregnant women." To help minimize medical radiation dose, eliminate unnecessary radiation exposure, and impart a pervasive culture of radiation safety at U.S. healthcare facilities, the commission will rely partially on requirements from the U.S. Centers for Medicare and Medicaid Services (CMS) that take effect in January 2012. Based on the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, these requirements mandate the accreditation of all non-hospital freestanding facilities that provide advanced diagnostic imaging services, including CT, MRI, PET, and nuclear medicine services. Even more stringent requirements take effect in California in January 2013. Specific actions recommended by the Joint Commission include the use of non-CT imaging techniques, such as ultrasound and MRI; collaboration between radiologists and referring physicians about the appropriate use of diagnostic imaging; and adherence to the Nuclear Regulatory Commission's ALARA (as low as reasonably achievable) guidelines. Recommended actions also include adherence to guidelines from the Society for Pediatric Radiology, the American College of Radiology (ACR), and the Radiological Society of North America (RSNA). The Joint Commission is also recommending assurance by radiologists that the proper dosing protocol is in place for the patient being treated, along with a review of all dosing protocols against the latest evidence at least every two years; expansion of the role of radiation safety officer to include patient safety relating to radiation and dosing, and education covering proper techniques and equipment usage for all physicians and technologists who prescribe exams that use radiation or the equipment. Additionally, the recommendations stipulate that centralized quality and safety performance monitoring be implemented for all imaging equipment that may emit high amounts of radiation. For the full text of the alert, click here: http://www.jointcommission.org/assets/1/18/SEA_471.PDF