EMERGING TRENDS IN PATENT SAFETY AND QUALITY IN MEDICAL IMAGING
EMERGING
TRENDS IN PATENT SAFETY AND QUALITY OF MEDICAL IMAGING
By
Prof.M.
THANGA DARWIN
INTRODUCTION
“Patient
safety is a precarious component of medical imaging quality
Improving
Quality through Patient Safety
Patient
safety is the cornerstone of high-quality health care and medical imaging. ”
In modern environment of rapid
growth and technological advancement, radiologic technologists face a number of
challenges when new and emerging technologies are introduced or when equipment
upgrades occur. Hence every technologist need to update their knowledge. This paper
focus on modern trends in safety and quality in medical imaging.
PATENT SAFETY
The simplest definition of
patient safety is the prevention of errors and adverse effects to patients
associated with health care. While health care has become more effective it has
also become more complex, with greater use of new technologies, medicines and
treatments.
QUALITY
IN MEDICAL IMAGING
The standard and excellence
of Medical Specialty that uses X-rays, gamma rays, high frequency sound waves,
magnetic fields or isotopes to produce images of organs and other internal
structure of the body. The specialty aims to detect & diagnose disease as well
as to carry out interventional procedures to confirm the diagnosis and treat
certain diseases and abnormalities.
10 TOP PATIENT
SAFETY ISSUES FOR 2016
1.
Medication errors.
2.
Diagnostic errors.
3.
Discharge
practices to post-acute, home care.
4.
Workplace safety.
5.
Hospital facility
safety.
6.
Reprocessing
issues.
7.
Sepsis.
8.
"Super"
superbugs.
9.
The
cyber-insecurity of medical devices.
10. Going transparent with quality data.
FACTS ON PATIENT
SAFETY - WHO
1.
Patient safety is a serious global public health issue.
2.
One in 10 patients may be harmed while in hospital.
3.
Hospital infections affect 14 out of every 100 patients admitted.
4.
Most people lack access to appropriate medical devices.
5.
Unsafe injections decreased by 88% from 2000 to 2010.
6.
Delivery of safe surgery requires a teamwork approach.
7.
About 20%–40% of all health spending is wasted due to poor-quality care.
8.
Delivery of safe surgery requires a teamwork approach.
9.
Patient and community engagement and empowerment are key.
10
Hospital partnerships can play a critical role.
INTERNATIONAL
CLASSIFICATION FOR PATIENT SAFETY INCIDENT TYPE
1. Clinical Administration
2.
Clinical Process/Procedure
3.
Documentation
4.
Healthcare Associated Infection
5.
Medication/IV Fluids
6.
Blood/Blood Products
7.
Nutrition
8.
Oxygen/Gas/Vapour
9.
Medical Device/Equipment
10.
Behaviour
11.
Patient Accidents
12.
Infrastructure/Building/Fixtures
13.
Resources/Organizational Management
INTERNATIONAL
PATIENT SAFETY GOALS
Goal 1 - Identify Patients
Correctly.
Goal 2 - Improve Effective Communication.
Goal 3 - Improve the safety of high-Alert
Medications.
Goal 4 - Ensure correct Site, Correct
Procedure, Correct Patient Surgery.
Goal 5 - Reduce Risk of Health
Care-Associates Infections.
Goal 6 - Reduce the Risk of Patient Harm
resulting from fall.
7 ALARA (“AS LOW
AS REASONABLY ACHIEVABLE”) A PRINCIPLES FOR REDUCING RADIATION EXPOSURE
How can you reduce external radiation exposure?
1.
Time:
Reducing the time of exposure can
directly reduce radiation dose.
2. Distance:
Increasing
the distance between you and the radiation source you will reduce exposure by
the square of the distance
3. Shielding:
Lead
or lead equivalent shielding for X-rays and gamma rays is an effective way to
reduce radiation exposure.
How can you
reduce internal radiation exposure?
4. Good Hygiene:
By
eliminating the presence of food and drink in areas where radioactive materials
are used or stored, and controlling “hand to mouth” habits, the risk of internal
radiation exposure is reduced.
5. Control of Contamination:
Labelling
radioactive and potentially radioactive areas and items will help prevent the
spread of contamination.
6. Airborne Hazards:
Using
fume hoods and avoiding dust, aerosol, or volatile gas production can reduce
the potential for inhalation of radioactive substances.
7. Use Proper PPE:
Using
the proper personal protective equipment (PPE) such as disposable gloves,
safety glasses, lab coats, etc
METHODOLOGICAL
APPROACHES TO DRIVING IMPROVEMENT OF SAFETY AND QUALITY
This
article introduced following methodological approaches to improving safety and
quality in medical imaging. They are
1. Total
quality management (TQM).
2.
Quality assurance.
3.
Model for
improvement.
4.
Enrich Workplace
Culture.
5.
Psychological
safety.
1. Total
quality management (TQM)
Total Quality Management (TQM) is a
comprehensive and structured approach to organizational management that seeks
to improve the quality of Medical Imaging and services through ongoing
refinements in response to continuous feedback by means of plan, do, check and act.
2.
Quality assurance
Quality Assurance
Programs for Diagnostic Radiology Facilities. “Quality assurance”
means the planned
and systematic actions
that provide adequate
confidence that a diagnostic x-ray facility will produce consistently
high quality images with minimum
exposure of the
patients and healing
arts personnel.
Quality
assurance actions include both “quality control” techniques and “quality
administration” through following procedures.
(1) Responsibility
(2) Purchase
specifications
(3) Monitoring
and maintenance
(4) Standards for image quality.
(5) Evaluation.
(6) Records
(7) Manual
(8) Training
(9) Committee.
(10) Review.
3.
Model for improvement
The Model for
Improvement, developed by Associates in Process Improvement, is a simple yet
powerful tool for accelerating improvement. The model is not meant to replace
change models that organizations may already be using, but rather to accelerate
improvement. This model has been used very successfully by hundreds of health care
organizations in many countries to improve many different health care processes
and outcomes.
The
model has two parts:
a.
Three fundamental questions, which
can be addressed in any order.
b.
The Plan-Do-Study-Act (PDSA) cycle to
test changes in real work settings. The PDSA cycle guides the test of a change
to determine if the change is an improvement.
4.
Enrich Workplace Culture
Culture is the character and personality
of health care organization. It's what makes your organization unique and is
the sum of its values, traditions, beliefs, interactions, behaviours, and
attitudes. Here's an overview of why workplace culture is important, what
affects it, and how to define it. Thorough
planning and strategizing in a safety-minded culture optimizes the use of tools
available for reporting and tracking estimated doses and for process
improvement. In medical imagining material and non-material cultural traits
should be enrich.
5. Psychological
safety
Psychological
safety is a shared belief that the team is safe for interpersonal risk taking.
In psychologically safe teams, team members feel accepted and respected. It is
also the most studied enabling condition in group dynamics and team learning
research.
Understanding and improving patient
safety the psychological, social and cultural dimensions. Compassionate care
for client in medical image settings. The patient psychological needs should be
fulfil for safety and quality of medical imaging .
STANDARDIZING PATENT SAFETY AND QUALITY IN
MEDICAL IMAGING IN INDIA
Emerging trend
in India is that every heath care imaging deportments should be accredited to
standardizing safety and quality.
National
accreditation board for hospitals & healthcare providers (NABH)
General Guidelines Pertaining to
all Diagnostic and Interventional Imaging Services
23 standards
95 objective
elements
Standards are
grouped into six chapters
CHAPTER
1 Control of Services:
a.
Medical Imaging Service ensures delivery of the service from point of referral
to discharge.
b.
Medical Imaging Service ensures that the delivery of services is patient
focused.
CHAPTER
2 Control of Imaging Processes and Procedures:
Medical Imaging Service ensures the
acquisition of optimal diagnostic quality images and performance of diagnostic
procedures.
b. Medical Imaging service ensures
the quality (clinical and technical) of reports
c. Medical Imaging service ensures
quality of interventional procedures
d. Medical Imaging service ensures
proper management of drugs and contrast media.
Chapter
3(CFE) Control of Facility and Environment:
a. Medical Imaging service ensures
proper management of facility
b. Medical Imaging service ensures
proper management of environment of the facility.
Chapter4 (CP) Control of Personnel:
a. Medical Imaging service ensures authorization,
management and support to staff to deliver the service.
b.
Medical Imaging Service ensures that the staff is competent to deliver the
service assigned to them.
c.
Medical Imaging Service ensures service and workforce review, planning and development.
Chapter
5(CE) Control of Equipment:
a. Medical Imaging Service ensures
appropriate procurement and installation of the equipment's.
b. Medical Imaging Service ensures
appropriate operation and working of the equipment's.
c. Medical Imaging Service ensures
appropriate maintenance and repair of the equipment’s.
d. Medical Imaging Service ensures
appropriate replacement of existing equipment &planning for new equipment
for continuation and expansion of service.
Chapter
6(CDR) Control of Documents and Record:
a. Medical Imaging Service ensures
generation, completion, revision, retention and dissemination of information
documents for staff, patients and others.
b. Medical Imaging Service ensures
procurement and maintenance of documents of legislative and statutory
requirements related to facility, equipment and risk monitoring.
c. Medical Imaging Services ensures
maintenance and updating of personnel data records of all staff.
Chapter 7 (RCS) Risk control and safety:
a. Medical Imaging Services ensure that the risk associated with imaging
a. Medical Imaging Services ensure that the risk associated with imaging
procedures are identified,
assessed, managed and minimised.
b.
Medical Imaging Service ensures that the risk of infection to staff, patient
and others is identified, assessed, managed and minimised.
c.
Medical Imaging Service ensures that the risk associated with hazardous
substances
and materials to staff, patient and others are identified, assessed,
managed
and minimised.
d.
Medical Imaging Service ensures that the risk of violence and aggression to
staff, patient and others are identified, assessed, managed and minimised.
e.
Medical Imaging Service ensures that the risk associated with fire,
electrocution and other disaster to staff, patient and others and to facility
and environment are identified, assessed, managed and minimise.
Benefits of Accreditation:
Benefits
for Patients
Benefits for Medical Imaging Service
Benefits for Medical Imaging Service Staff
Benefits to paying and regulatory bodies
Benefits for Medical Imaging Service
Benefits for Medical Imaging Service Staff
Benefits to paying and regulatory bodies
BEST PRACTICE
Efforts focus on better facilitating
radiologist/radiologic technologist collaboration on care, feedback and
quality improvement.
Medical imaging departments develop staffing policies
and procedures that facilitate safe patient care.
Medical imaging departments provide
effective and efficient applications training for new and
upgraded medical imaging equipment.
Medical imaging departments have quality
management processes in place; vendors provide documentation and
analysis tools that management uses effectively
CONCLUSION
Patients now have more
information than ever and are empowered to understand the importance of safety
and dose when undergoing medical imaging procedures. Radiologic technologists
are poised to educate and protect patients. Collaboration of medical imaging
stakeholders to support radiologic technologists’ education and efforts and to
promote a culture of safety and lifelong learning can effect change in medical
imaging.
References:
1.
Top 10 Patient Safety Concerns for
Healthcare Organizations: https://www.ecri.org/Pages/Top-10-Patient-Safety-Concerns.aspx
2.
7 ALARA Principles for Reducing
Radiation Exposure: http://blog.universalmedicalinc.com/7-alara-principles-for-reducing-radiation-exposure/
3.
Patient Safety and Quality in
Medical Imaging: The Radiologic Technologist’s Role: https://www.asrt.org/docs/default-source/whitepapers/asrt13_patientsafetyqltywhitepaper.pdf?sfvrsn=6
4.
Conceptual Frame work for the
International Classification for Patient Safety:http://www.who.int/patientsafety/taxonomy/icps_full_report.pdf
5.
Global Initiative on Radiation
Safety in Healthcare Settings: http://www.who.int/ionizing_radiation/about/GI_TM_Report_2008_Dec.pdf?ua=1
6.
Hospital National Patient Safety
Goals: https://www.jointcommission.org/assets/1/6/2016_NPSG_HAP_ER.pdf
7. NABH
accreditation of medical imaging services: http://nabh.co/Images/PDF/mis- gib.pdf
8. The
psychological and social needs of patients
9. Quality
Assurance Programs for Diagnostic Radiology Facilities
10. To download - Quality Council of India
11. The incidence of diagnostic error in medicine
12.
10 top patient safety issues for 2016
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