Risk Management in Radiology Units: Managing an Acute Adverse Event in a Radiology Department

Abstract

1. Introduction to Radiology Units and Risk Management
Radiology units in a hospital or clinic encompass a set of discrete functional areas where collectively large numbers of imaging procedures are performed. Diagnostic radiology alone typically accounts for more than 95% of all imaging studies, using a diverse menu of imaging techniques that include X-rays, ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. Most of these radiology procedures are performed on an outpatient basis. The unique feature of the utilization pattern in a radiology unit is the concentration of a large number of imaging procedures in a relatively short period of time. This high-throughput characteristic is inherent to the design and function of a radiology unit. High-performance expectations, in fact, underlie the hierarchical organization and associated management structure of a typical radiology department.
Methods
Hospital radiology departments are at risk for a variety of acute adverse events. Events with high morbidity or mortality associated with a short time frame for onset after a triggering event require the development of a predetermined structured response or an emergency protocol. Events of this nature that can occur in a radiology department include: contrast media reaction, cardiopulmonary arrest, fire, and active shooter. This text reviews the components of developing an acute event response for these events and using a model of Six Sigma as a methodology can provide a method to standardize and evaluate the quality of the response.
Conclusion
In conclusion, radiology units face several unique risks, in addition to the more common risks that are associated with medical services in general. Radiology risks are dynamic, and interaction with the patients is usually brief. Management of contrast media is one of the major concerns of risk management in the radiology department. The rare occurrence of acute adverse events is no excuse to be unprepared, as the consequence of delayed treatment can be life-threatening. Protocols need to be in place with a clear division of responsibilities to ensure that an appropriately trained person responds to the event in a timely manner. Risk management in the radiology department extends beyond ensuring the safety of radiological procedures performed. It also includes all identified risks associated with equipment, environment, and staff. Regular audits and incident reporting should be encouraged to enable a proactive approach in preventing adverse events. Staff who are adequately trained and experienced are less likely to make errors and should become the focus of risk management. In addition, the concept of patient safety extends to successive encounters in the department, and interpersonal risks, including risks of violence against staff, should be addressed.