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Chau M. Enhancing safety culture in radiology: Key practices and recommendations for sustainable excellence. Radiography (Lond) 2024; 30 Suppl 1:9-16. [PMID: 38797116 DOI: 10.1016/j.radi.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES This review aims to explore and thematically synthesize the existing literature on safety culture within the context of radiology. The primary objective is to identify key practices that effectively strengthen safety culture, highlighting the pivotal roles of leadership, effective teamwork, and interprofessional collaboration in these efforts. The review intends to showcase actionable recommendations that are particularly relevant to the radiology setting. KEY FINDINGS The study highlights that effective leadership is fundamental in establishing and nurturing a safety-first approach within radiology departments. Key practices for promoting a safety culture include safety huddles, leadership walkarounds, quality learning boards, intentional patient rounding (frequent patient-care provider interactions), morbidity and mortality meetings, and multidisciplinary team rounds. These practices have been found to facilitate open communication and transparency, which are crucial elements in creating a sustainable safety culture. Additionally, the study underscores the significant role of radiology managers in driving these safety initiatives and acting as facilitators for a culture of safety, focused on long-term excellence and continuous improvement. CONCLUSION The study concludes that a multifaceted and comprehensive approach is vital for fostering a safety culture in radiology departments, with a focus on sustainable excellence in patient care. The leadership role is critical in this process, with radiology managers being instrumental in implementing and maintaining effective safety practices. IMPLICATIONS FOR PRACTICE This study provides best practices for sustainable safety culture in radiology departments. It advocates for healthcare managers to adopt and integrate these identified practices into their operational strategies. Continuous professional development, focusing on safety and quality in patient care, and fostering a collaborative environment for open discussion and learning from safety incidents are essential for the continued advancement and excellence of healthcare services.
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Affiliation(s)
- M Chau
- Faculty of Science and Health, Charles Sturt University, Level 5, 250 Boorooma St, NSW 2678, Australia; South Australia Medical Imaging, Flinders Medical Centre, 1 Flinders Drive, Bedford Park, SA 5042, Australia.
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Oliveira M, Navarro M, Costa E, Kremer D, Pinheiro R, Freitas V, Modesto I, Macedo E, Ferreira J, Andrade D, Damasceno L, Joseneas E. Potential risk assessment: a model for quality evaluation in fluoroscopy-guided interventional procedures. RADIATION PROTECTION DOSIMETRY 2024; 200:693-699. [PMID: 38679858 DOI: 10.1093/rpd/ncae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/06/2024] [Accepted: 04/04/2024] [Indexed: 05/01/2024]
Abstract
This study presented a model applied for potential risk assessment in an interventional radiology setting. The model of potential risk assessment (MARP) consisted of the creation of a scale of indicators ranging from 0 to 5. The radiation levels were categorized according to gender, kind of procedure, value of kerma air product (Pka), and accumulated radiation dose (mGy). The MARP model was applied in 121 institutions over 8 y. A total of 201 656 patient radiation doses (Dose-area product and accumulated kerma) data were launched into the system over time, with an average of 22 406 doses per year. In the context of the workers (cardiologists, radiographers, and nurses) monitored during the MARP application, 8007 cases (with an average of 890 per year) of occupational radiation doses were recorded. This study showed a strategy for quality evaluation in fluoroscopy using a model with a compulsory information system for monitoring safety.
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Affiliation(s)
- Marcus Oliveira
- Department of Health Technology and Biology, Federal Institute of Bahia, Salvador, 40301-015, Brazil
- Labprosaud, Laboratório de Produtos para a Saúde do IFBA, Salvador, BA 41745-715, Brazil
| | - Marcus Navarro
- Department of Health Technology and Biology, Federal Institute of Bahia, Salvador, 40301-015, Brazil
- Labprosaud, Laboratório de Produtos para a Saúde do IFBA, Salvador, BA 41745-715, Brazil
| | - Eliana Costa
- Universidade do Estado da Bahia, Departamento de Ciências da vida, Salvador, BA 41.150-000, Brasil
| | - Djeimis Kremer
- Vigilância Sanitária do Estado de Santa Catarina, Gerência de Saúde do Trabalhador - GESAT, Florianópolis, Santa Catarina, 88015-200, Brasil
| | - Regina Pinheiro
- Vigilância Sanitária do Estado de Santa Catarina, Gerência de Saúde do Trabalhador - GESAT, Florianópolis, Santa Catarina, 88015-200, Brasil
| | - Vanessa Freitas
- Sociedade Brasileira de Avaliação de Risco, Salvador, Bahia 40.279-120, Brasil
| | - Igor Modesto
- Labprosaud, Laboratório de Produtos para a Saúde do IFBA, Salvador, BA 41745-715, Brazil
| | - Erik Macedo
- Labprosaud, Laboratório de Produtos para a Saúde do IFBA, Salvador, BA 41745-715, Brazil
| | - Jeovana Ferreira
- Labprosaud, Laboratório de Produtos para a Saúde do IFBA, Salvador, BA 41745-715, Brazil
| | - Daniele Andrade
- Labprosaud, Laboratório de Produtos para a Saúde do IFBA, Salvador, BA 41745-715, Brazil
| | - Lauro Damasceno
- Sociedade Brasileira de Avaliação de Risco, Salvador, Bahia 40.279-120, Brasil
| | - Enoque Joseneas
- Sociedade Brasileira de Avaliação de Risco, Salvador, Bahia 40.279-120, Brasil
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Hill S, Jimenez YA, Abu Awwad D, Lewis SJ. Infection prevention and control in computed tomography: creating a national survey. Infect Dis Health 2024; 29:15-24. [PMID: 37813714 DOI: 10.1016/j.idh.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Infection prevention and control (IPC) is essential for quality healthcare, with healthcare associated infections (HAI) a known risk to patients requiring medical imaging (MI). To date, few papers have adopted a national approach to understanding or benchmarking the knowledge of, attitudes toward, and practice (KAP) of IPC in the context of MI and no validated surveys or scales are identified in the literature. The Computed Tomography (CT) suite is a unique MI environment where radiographers deliver prescription medicines to patients via intravenous (IV) means through an injector system. This paper describes the development of a survey that informs the use of IPC processes in the CT suite. METHODS Standard Precautions via current national guidelines formed the benchmark of the survey, with a KAP survey used as the framework to explore IPC. The questions and associated responses are developed based on the National Health and Medical Research Council (NHMRC) guidelines, industry/professional protocols and adapted to the equipment and practices commonly used in the CT suite of MI departments by radiographers and nurses. RESULTS Key survey development steps are described to include the justification of the benchmarking source, the survey framework and design. Detailed information is given to show the evolution of truth statements and sources, KAP question variations, and rationales for the methodology of question responses. National guidelines are mapped to survey questions and responses and pilot testing reflections are included. CONCLUSION This paper reports on the construction of a standardised KAP survey for IPC specific to the CT suite in the Australian healthcare setting. The survey is ready for dissemination amongst MI departments. Documented use will aid validation and reliability as a survey tool to measure and map IPC specifically in relation to IV contrast administration.
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Affiliation(s)
- Suzanne Hill
- Discipline of Medical Imaging Sciences, Faculty of Medicine and Health, The University of Sydney. 1 Science Road, Camperdown, NSW, 2006, Australia
| | - Yobelli A Jimenez
- Discipline of Medical Imaging Sciences, Faculty of Medicine and Health, The University of Sydney. 1 Science Road, Camperdown, NSW, 2006, Australia
| | - Dania Abu Awwad
- Discipline of Medical Imaging Sciences, Faculty of Medicine and Health, The University of Sydney. 1 Science Road, Camperdown, NSW, 2006, Australia
| | - Sarah J Lewis
- Discipline of Medical Imaging Sciences, Faculty of Medicine and Health, The University of Sydney. 1 Science Road, Camperdown, NSW, 2006, Australia.
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Abu Awwad D, Hill S, Lewis S, Jimenez YA. Infection prevention and control in CT Part 1: An Australian study of roles, responsibilities and practices. Radiography (Lond) 2024; 30:245-251. [PMID: 38035440 DOI: 10.1016/j.radi.2023.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/26/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The computed tomography (CT) suite presents Infection Prevention and Control (IPC) risks for staff and patients. This is the first of a two-part series on IPC in the CT setting and reports on Australian baseline data related to intravenous contrast media administration and the use of power injectors in the CT suite, including knowledge sources related to the delivery of contrast media. The second part provides insights into CT staff's perceptions of high-risk scenarios for non-adherence to standard or transmission-based precautions. METHODS The study employed an online survey design, directed at radiographers and radiology nurses working in Australia. The survey included questions relating to CT workplace staffing and equipment, contrast media use and occupational roles, and knowledge sources used for infection control and contrast injectors. RESULTS Overall, 160 study participants completed the survey (radiographers: n = 138, 86.3%; nurses: n = 22, 13.7%). Differences were identified between public and private practice. Public hospitals completed more contrast-enhanced scans, and with dual injecting systems, operated and cleaned by radiographers and nurses. Private clinics generally used single-system, power injectors. Radiographers and nurses relied heavily on their colleagues and product guidelines for IPC information. IPC teams were uncommon in private clinics, very common in public departments and 50% of respondents had undertaken IPC training in the last 12 months. CONCLUSION Insights into use and duties of professionals delivering intravenous contrast media administration using power injectors in the CT suite will help to inform decision-making processes on IPC education strategies and map risk. IMPLICATION FOR PRACTICE Future research should focus on how radiology workers in CT perceive IPC risk and/or might vary from best practice, which has direct clinical implications for safety if contamination, or incorrect information is routinely applied.
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Affiliation(s)
- D Abu Awwad
- Faculty of Medicine and Health, Discipline of Medical Imaging Science, Susan Wakil Health Building (D18), Western Avenue, University of Sydney, NSW 2006, USA
| | - S Hill
- Faculty of Medicine and Health, Discipline of Medical Imaging Science, Susan Wakil Health Building (D18), Western Avenue, University of Sydney, NSW 2006, USA
| | - S Lewis
- Faculty of Medicine and Health, Discipline of Medical Imaging Science, Susan Wakil Health Building (D18), Western Avenue, University of Sydney, NSW 2006, USA. https://twitter.com/@SarahLewisUSYD
| | - Y A Jimenez
- Faculty of Medicine and Health, Discipline of Medical Imaging Science, Susan Wakil Health Building (D18), Western Avenue, University of Sydney, NSW 2006, USA.
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Pearce B, Nguyên VNB, Cowling C, Pinson JA, Sim J. Australian radiographer roles in the emergency department; evidence of regulatory compliance to improve patient safety - A narrative review. Radiography (Lond) 2024; 30:319-331. [PMID: 38128248 DOI: 10.1016/j.radi.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Using a narrative approach, this paper aims to determine the extent of Australian radiographers' regulatory compliance to improve patient safety when performing appendicular X-ray and non-contrast brain computed tomography (CT) in the Emergency Department (ED). KEY FINDINGS A narrative review explored relevant literature and key regulatory policy. Ten documents were identified, three main themes were developed related to the radiographer roles in X-ray request justification, dose optimisation and preliminary image evaluation (PIE). Radiographers were equally aware of justification and optimisation pre and post the introduction of a Medical Code of Practice. The collective PIE accuracy of radiographers remained unaffected by changes in mode of PIE delivery and regulatory factors but varied based on the anatomical region. CONCLUSION While current Australian regulations mandate radiographer request justification, dose optimisation and PIE, the degree of compliance by Australian radiographers remains uncertain. Current literature provides evidence that radiographers can improve patient care and safety through justification, optimisation, and PIE delivery. Change in workplace practice, supported by key stakeholders including radiologists, is essential to integrate radiographers' functions into routine ED clinical practice. Further research is required to audit radiographers' regulatory compliance to improve patient safety. IMPLICATIONS FOR PRACTICE Patient safety in ED can be improved with timely and accurate diagnosis provided by radiographers. Radiographers have a professional obligation to adhere to the capabilities and standards for safe medical radiation practice defined by Australian regulations. Therefore, radiographers must justify the X-ray request, optimise the radiation dose where appropriate and communicate urgent or unexpected findings to the referrer.
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Affiliation(s)
- B Pearce
- Peninsula Health: Frankston Hospital, Frankston, Victoria, Australia; Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Victoria, Australia.
| | - Van N B Nguyên
- Monash Nursing & Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC, Australia
| | - C Cowling
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Victoria, Australia
| | - J-A Pinson
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Victoria, Australia
| | - J Sim
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Victoria, Australia
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Wallin A, Bazzi M, Ringdal M, Ahlberg K, Lundén M. Radiographers' perception of patient safety culture in radiology. Radiography (Lond) 2023; 29:610-616. [PMID: 37086589 DOI: 10.1016/j.radi.2023.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/10/2023] [Accepted: 04/05/2023] [Indexed: 04/24/2023]
Abstract
INTRODUCTION Radiographers play a central role in patient safety because of their knowledge of and responsibilities in relation to the imaging process. To maintain safe care, the workplace must create a safety culture that enables sustainable safety work. AIM This study aims to describe radiographers' perceptions of the patient safety culture in radiology units in Sweden. METHODS The Swedish Hospital Survey of Patients' Safety Culture (S-HSOPSC) was used to gather descriptive data from 171 Swedish registered radiographers working in five radiology clinics distributed across 15 units. Fifty-one questionnaire items and one open-ended question were analysed, comprising perceptions of the overall safety grade, the frequency of number of reported risks and events, and 14 composites regarding patient safety dimensions. RESULTS The radiographers' concerns surrounding the patient safety culture in their workplaces related to weaknesses regarding the safety dimensions "Staffing", "Frequency of error reporting", "Organizational learning - continuous improvement" and "Executive management support for patient safety". They perceived "Teamwork within the unit" to be a strength. CONCLUSION Despite some weaknesses in the patient safety culture, the radiographers perceived that the overall patient safety level was good, in part because of their ability to spot risks in time. The executive management, however, needed to improve their feedback on safety measures; and another reason for some weaknesses in the patient safety culture could be staffing issues such as lack of time for meetings for continuous improvement. Managers and leaders have a great responsibility to establish a patient safety culture through support and good leadership. IMPLICATIONS FOR PRACTICE An understanding of what creates a safety culture is important to prevent patient safety incidents.
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Affiliation(s)
- A Wallin
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Sweden.
| | - M Bazzi
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - M Ringdal
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - K Ahlberg
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - M Lundén
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Sweden
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Kumari D, Ahmed O, Jilani S, Funaki E, Funaki B. A Review of Professional Liability in IR: Sweeping the Mines. J Vasc Interv Radiol 2023; 34:157-163. [PMID: 36241149 DOI: 10.1016/j.jvir.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Medical professional liability (MPL) is becoming a substantial issue in interventional radiology (IR), with both impact on health care costs and negative psychological effects on physicians. MPL presents special challenges within IR because of the field's complex and innovative therapies that are provided to a diverse group of patients and complicated by the off-label use of devices and drugs that is pervasive in the field. This review discusses the principles and practices to avoid and manage MPLs that are specific to the field of IR.
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Affiliation(s)
- Divya Kumari
- Department of Radiology, University of Chicago Medicine, Chicago, Illinois.
| | - Osman Ahmed
- Department of Radiology, University of Chicago Medicine, Chicago, Illinois
| | | | | | - Brian Funaki
- Department of Radiology, University of Chicago Medicine, Chicago, Illinois
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Wallin A, Ringdal M, Ahlberg K, Lundén M. Radiographers' experience of preventing patient safety incidents in the context of radiological examinations. Scand J Caring Sci 2022; 37:414-423. [PMID: 36285791 DOI: 10.1111/scs.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/17/2022] [Accepted: 09/24/2022] [Indexed: 11/28/2022]
Abstract
AIM To describe factors that prevent patient safety incidents in connection with the radiological examination from the radiographer's perspective. BACKGROUND Radiology plays an important role in the care chain and involves diagnostic examinations and treatments using various radiation sources and different techniques. Risks for patient safety incidents exist in every phase of a radiological examination. Appropriate use of medical imaging requires a multidisciplinary approach involving staff of different categories to meet the medical objectives and the patient's care needs. In accordance with a Safety-II approach, it is therefore important to understand why things go right and ensure that they do by supporting the conditions for right things to happen. DESIGN A qualitative study with a descriptive design. METHODS Semi-structured interviews were conducted with 17 radiographers. The data were analysed using theoretical thematic analysis based on the Systems Engineering Initiative for Patient Safety model. RESULTS The analysis yielded 20 sub-themes, which describe different success factors contributing to patient safety. CONCLUSION Proactive work should focus on collaboration and sharing the necessary knowledge, internally and externally, for care in connection with the radiological examination. The radiological and peri-radiographic knowledge should include monitoring the patient's safety needs before, during and after the radiological examination. The referring clinician has a central role in writing relevant referrals and the radiographer's competence is crucial in monitoring the patient's safety needs. A good patient safety culture is required and working with standards is important.
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Affiliation(s)
- Agneta Wallin
- Sahlgrenska Academy, Institute of Health and Care Sciences University of Gothenburg Gothenburg Sweden
| | - Mona Ringdal
- Sahlgrenska Academy, Institute of Health and Care Sciences University of Gothenburg Gothenburg Sweden
| | - Karin Ahlberg
- Sahlgrenska Academy, Institute of Health and Care Sciences University of Gothenburg Gothenburg Sweden
| | - Maud Lundén
- Sahlgrenska Academy, Institute of Health and Care Sciences University of Gothenburg Gothenburg Sweden
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Speaking-up for patient safety: A scoping narrative review of international literature and lessons for radiography in Ghana and other resource-constrained settings. Radiography (Lond) 2022; 28:919-925. [PMID: 35820354 DOI: 10.1016/j.radi.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/08/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Employees 'speaking-up', or raising concerns about unsafe practices, has gained traction across healthcare, however, the topic has not been widely discussed within radiography generally or within resource-constrained healthcare settings. A systematic scoping narrative review identified the experiences of radiographers in speaking-up about safety concerns, which was extended to healthcare professionals more broadly. The scope of the review was further extended to cover speaking-up in non-healthcare resource-constrained settings in Africa. KEY FINDINGS Sixty-three studies were included in the review. The majority originated from westernised and/or higher resource health systems, with a dearth of literature from Africa and other resource-constrained settings. Several studies identified barriers and enablers confronting healthcare workers wishing to speak-up. While 'speaking-up' as a concept has gained international interest, most studies are, however, focussed on nursing and medical practice contexts, overlooking other healthcare professions, including radiography. The findings are synthesised into a series of key lessons for healthcare and radiography practitioners in Ghana and other resource-constrained settings. CONCLUSION The topic has been largely overlooked by policy makers, both within healthcare generally and specifically within radiography in Ghana. This is particularly concerning given the many complexities and risks inherent to radiography. A radiography and a healthcare workforce lacking in voice is poorly positioned to improve workers' safety and patient safety. More generally, promoting speaking up could enhance Ghana's ambitions to deliver a high-quality health care system and Universal Health Coverage (UHC) in the future. IMPLICATIONS FOR PRACTICE National and regional policy makers need to implement speaking-up processes and procedures reflecting the lessons of the literature review, such as ensuring no detriment as result of speaking-up and making staff feel that their concerns are not futile. Speaking-up processes should be implemented by individual organisations, alongside staff training and monitoring.
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Pourvaziri A, Narayan AK, Tso D, Baliyan V, Glover M, Bizzo BC, Kako B, Succi MD, Lev MH, Flores EJ. Imaging Information Overload: Quantifying the burden of interpretive and non-interpretive tasks for CT angiography for aortic pathologies in emergency radiology. Curr Probl Diagn Radiol 2022; 51:546-551. [DOI: 10.1067/j.cpradiol.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/18/2021] [Accepted: 01/05/2022] [Indexed: 12/20/2022]
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Alves CL, Oliveira JS, Tannus A, Tarpani ACSP, Tarpani JR. Detection and Imaging of Damages and Defects in Fibre-Reinforced Composites by Magnetic Resonance Technique. MATERIALS 2021; 14:ma14040977. [PMID: 33669603 PMCID: PMC7921926 DOI: 10.3390/ma14040977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/22/2022]
Abstract
Defectively manufactured and deliberately damaged composite laminates fabricated with different continuous reinforcing fibres (respectively, carbon and glass) and polymer matrices (respectively, thermoset and thermoplastic) were inspected in magnetic resonance imaging equipment. Two pulse sequences were evaluated during non-destructive examination conducted in saline solution-immersed samples to simulate load-bearing orthopaedic implants permanently in contact with biofluids. The orientation, positioning, shape, and especially the size of translaminar and delamination fractures were determined according to stringent structural assessment criteria. The spatial distribution, shape, and contours of water-filled voids were sufficiently delineated to infer the amount of absorbed water if thinner image slices than this study were used. The surface texture of composite specimens featuring roughness, waviness, indentation, crushing, and scratches was outlined, with fortuitous artefacts not impairing the image quality and interpretation. Low electromagnetic shielding glass fibres delivered the highest, while electrically conductive carbon fibres produced the poorest quality images, particularly when blended with thermoplastic polymer, though reliable image interpretation was still attainable.
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Affiliation(s)
- Carine L. Alves
- Materials Engineering Department, Engineering School of São Carlos, University of São Paulo, São Carlos, SP 13590-566, Brazil; (C.L.A.); (J.S.O.); (A.C.S.P.T.)
| | - Janete S. Oliveira
- Materials Engineering Department, Engineering School of São Carlos, University of São Paulo, São Carlos, SP 13590-566, Brazil; (C.L.A.); (J.S.O.); (A.C.S.P.T.)
| | - Alberto Tannus
- Physics and Informatics Department, Physics Institute of São Carlos, University of São Paulo, São Carlos, SP 13590-566, Brazil;
| | - Alessandra Cristina Soares P. Tarpani
- Materials Engineering Department, Engineering School of São Carlos, University of São Paulo, São Carlos, SP 13590-566, Brazil; (C.L.A.); (J.S.O.); (A.C.S.P.T.)
| | - José R. Tarpani
- Materials Engineering Department, Engineering School of São Carlos, University of São Paulo, São Carlos, SP 13590-566, Brazil; (C.L.A.); (J.S.O.); (A.C.S.P.T.)
- Correspondence:
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Marcu M, Hedesiu M, Bogdan L, Armencea G, Manea A, Roman R, Vacaras S, Haba D, Porumb A, Baciut M, Crisan S. Financial efficiency estimation for a dental radiology laboratory. Med Pharm Rep 2020; 93:200-209. [PMID: 32478328 PMCID: PMC7243887 DOI: 10.15386/mpr-1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/05/2019] [Accepted: 11/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background and aims Considering nowadays trend among dentists to install a radiology laboratory beside their current practice, we proposed to investigate the aspect of financial efficiency related to such investment. Methods We evaluate two existing options: simple investment, consisting of intra-oral equipment and accessories, or investment in a radiology center that includes panoramic and CBCT equipment. The initial investment includes equipment acquisition, fitting out of the location, radiology accreditation and other miscellaneous expenses. Costs were estimated based on current quotations on the specific market available in Romania. We also described a financial model to estimate the financial risk. Results The analysis was made under the assumptions that the laboratory is operated by the dentist who made the investment in the form of a legal person and paying corporate tax like all Romanian entities. The analysis took into account current fees for different types of X-rays, usual expenses of such a laboratory, and describes the approach to this analysis, starting with the initial investment estimation and forecast of revenues and expenses. Based on these projections and assessment of the working capital, we have built the cash flows forecast. Following a risk analysis we could assess the financial efficiency of the two investment alternatives. Conclusions Our study reveals that the radiology center represents a more profitable investment due to the higher economic return rate.
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Affiliation(s)
- Maria Marcu
- Department of Oral Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Oral Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Loredana Bogdan
- Department of Oral Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Maxillofacial Surgery, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Avram Manea
- Department of Maxillofacial Surgery, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Roman
- Department of Oral Radiology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Vacaras
- Department of Maxillofacial Surgery, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Danisia Haba
- Department of Surgery (Dental and Maxillo-Facial Surgery), Faculty of Dentistry, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Anca Porumb
- Department of Dental Medicine, University of Oradea, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorana Crisan
- FSEGA, "Babes-Bolyai" University, Cluj-Napoca, Romania
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Jabin MSR, Magrabi F, Hibbert P, Schultz T, Runciman W. Identifying and Classifying Incidents Related to Health Information Technology in Medical Imaging as a Basis for Improvements in Practice. 2019 IEEE INTERNATIONAL CONFERENCE ON IMAGING SYSTEMS AND TECHNIQUES (IST) 2019. [DOI: 10.1109/ist48021.2019.9010109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
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Hulson O. Litigation claims in relation to radiology: what can we learn? Clin Radiol 2018; 73:893-901. [DOI: 10.1016/j.crad.2018.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/24/2018] [Indexed: 12/22/2022]
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Wallin A, Gustafsson M, Anderzen Carlsson A, Lundén M. Radiographers' experience of risks for patient safety incidents in the radiology department. J Clin Nurs 2018; 28:1125-1134. [PMID: 30257057 DOI: 10.1111/jocn.14681] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/28/2018] [Accepted: 09/15/2018] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES To describe potential risks for patient safety incidents in the radiology department from a radiographer's perspective. BACKGROUND A radiology department is a high-tech environment with high communication activity between different healthcare systems in combination with a large patient flow. Risks for patient safety incidents exist in every phase of a radiological examination. Due to the nature of the activity, a radiology department needs to have its own range of measures to prevent risks linked to radiology. DESIGN A qualitative descriptive design. METHODS Semi-structured interviews were carried out with 17 radiographers during the period September 2015 to February 2016. The data were analysed using conventional content analysis. This study followed the COREQ checklist criteria for the reporting of qualitative research. RESULTS The analysis yielded 20 different patient safety incidents that could result in the following six types of healthcare-associated harm: Patients could be exposed to unnecessary radiation; patients could receive an inaccurate diagnosis; patients could incur drug-induced damage; patients could suffer direct physical injury; or, their examination and treatment could be delayed or not carried out; or, their general health condition could deteriorate. CONCLUSION Lack of communication and knowledge, both internally and externally, can increase risks for patient safety incidents. The study describes a complex chain of activities that represent risks in the radiology department. It needs to be pointed out that it is not always the activities in the radiology department that cause the harm. RELEVANCE TO CLINICAL PRACTICE To carry out preventive patient safety work, a comprehensive analysis of the entire care chain is required. Patient safety work should also focus on improvement in communication both internally, within the radiology department, and externally. Standardised methodological guidelines, consistent prescriptions of method from the radiologist and a good working environment are internal success factors for patient safety at the radiology department.
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Affiliation(s)
- Agneta Wallin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Health Sciences, Örebro University, Örebro, Sweden
| | | | - Agneta Anderzen Carlsson
- School of Health Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Maud Lundén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Health Sciences, Örebro University, Örebro, Sweden
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Interrigi MC, Trovato FM, Catalano D, Trovato GM. Emergency thoracic ultrasound and clinical risk management. Ther Clin Risk Manag 2017; 13:151-160. [PMID: 28223817 PMCID: PMC5308587 DOI: 10.2147/tcrm.s126770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. PATIENTS AND METHODS This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. RESULTS Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural-pulmonary disease in emergency are good, with accuracy >95%. CONCLUSION About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and specificity. The contribution of expert telementoring and final reappraisal is a valuable and sustainable element for emergency physicians' training and performance, contributing reasonably to mitigation of clinical risks.
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Affiliation(s)
| | - Francesca M Trovato
- Accident and Emergency Department, Ospedale Civile, Ragusa
- Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania
| | - Daniela Catalano
- Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania
- Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania
| | - Guglielmo M Trovato
- Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania
- Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy
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Jabin SR, Schultz T, Hibbert P, Mandel C, Runciman W. Effectiveness of quality improvement interventions for patient safety in radiology: a systematic review protocol. ACTA ACUST UNITED AC 2016; 14:65-78. [PMID: 27755318 DOI: 10.11124/jbisrir-2016-003078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to find the best available evidence regarding effectiveness of quality improvement interventions in clinical radiology and the experiences and perspectives of staff and patients. More specifically, the review questions are.
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Affiliation(s)
- Shafiqur Rahman Jabin
- 1Centre for Population Health Research, University of South Australia, Adelaide, South Australia, Australia 2Centre for Evidence-based Practice South Australia (CEPSA): a Joanna Briggs Institute Centre of Excellence 3Department of Radiology/Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
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Frequency and analysis of non-clinical errors made in radiology reports using the National Integrated Medical Imaging System voice recognition dictation software. Ir J Med Sci 2016; 185:921-927. [PMID: 27696148 DOI: 10.1007/s11845-016-1507-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 09/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Voice recognition (VR) dictation of radiology reports has become the mainstay of reporting in many institutions worldwide. Despite benefit, such software is not without limitations, and transcription errors have been widely reported. AIM Evaluate the frequency and nature of non-clinical transcription error using VR dictation software. METHODS Retrospective audit of 378 finalised radiology reports. Errors were counted and categorised by significance, error type and sub-type. Data regarding imaging modality, report length and dictation time was collected. RESULTS 67 (17.72 %) reports contained ≥1 errors, with 7 (1.85 %) containing 'significant' and 9 (2.38 %) containing 'very significant' errors. A total of 90 errors were identified from the 378 reports analysed, with 74 (82.22 %) classified as 'insignificant', 7 (7.78 %) as 'significant', 9 (10 %) as 'very significant'. 68 (75.56 %) errors were 'spelling and grammar', 20 (22.22 %) 'missense' and 2 (2.22 %) 'nonsense'. 'Punctuation' error was most common sub-type, accounting for 27 errors (30 %). Complex imaging modalities had higher error rates per report and sentence. Computed tomography contained 0.040 errors per sentence compared to plain film with 0.030. Longer reports had a higher error rate, with reports >25 sentences containing an average of 1.23 errors per report compared to 0-5 sentences containing 0.09. CONCLUSION These findings highlight the limitations of VR dictation software. While most error was deemed insignificant, there were occurrences of error with potential to alter report interpretation and patient management. Longer reports and reports on more complex imaging had higher error rates and this should be taken into account by the reporting radiologist.
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Trovato FM, Catalano D, Trovato GM. Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients. World J Radiol 2016; 8:775-784. [PMID: 27721940 PMCID: PMC5039673 DOI: 10.4329/wjr.v8.i9.775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/11/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023] Open
Abstract
Imaging workup of patients referred for elective assessment of chest disease requires an articulated approach: Imaging is asked for achieving timely diagnosis. The concurrent or subsequent use of thoracic ultrasound (TUS) with conventional (chest X-rays-) and more advanced imaging procedures (computed tomography and magnetic resonance imaging) implies advantages, limitations and actual problems. Indeed, despite TUS may provide useful imaging of pleura, lung and heart disease, emergency scenarios are currently the most warranted field of application of TUS: Pleural effusion, pneumothorax, lung consolidation. This stems from its role in limited resources subsets; actually, ultrasound is an excellent risk reducing tool, which acts by: (1) increasing diagnostic certainty; (2) shortening time to definitive therapy; and (3) decreasing problems from blind procedures that carry an inherent level of complications. In addition, paediatric and newborn disease are particularly suitable for TUS investigation, aimed at the detection of congenital or acquired chest disease avoiding, limiting or postponing radiological exposure. TUS improves the effectiveness of elective medical practice, in resource-limited settings, in small point of care facilities and particularly in poorer countries. Quality and information provided by the procedure are increased avoiding whenever possible artefacts that can prevent or mislead the achievement of the correct diagnosis. Reliable monitoring of patients is possible, taking into consideration that appropriate expertise, knowledge, skills, training, and even adequate equipment’s suitability are not always and everywhere affordable or accessible. TUS is complementary imaging procedure for the radiologist and an excellent basic diagnostic tool suitable to be shared with pneumologists, cardiologists and emergency physicians.
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