in these areas. Recording of patient
dose from CT examinations in patients’
charts was low among Nebraska hospitals
surveyed—only 5% stated that physicians
record doses in patients’ charts. There
are probably several contributing factors
for hospitals not focusing on this issue.
There are major technological hurdles in
collecting this information. In addition,
a new paradigm defining responsibility
for tracking and monitoring imaging
appropriateness given a complex medical/
exposure history may be needed. This
will require a better understanding of
how this information is best utilized for
effective patient management.
Finally, 70% of respondents had seen
or reviewed The Joint Commission’s
Sentinel Event Alert prior to receiving
the survey. Again, the reasons why 30%
of respondents had not seen the alert are
unknown. Depending on distribution
and specific circumstances, the responses could indicate communication issues
within hospital organizations if issues
critical to radiologist and radiology manager participation are not communicated
from hospital-wide management.
Limitations to this project include
a limited sample size, which produced
a high standard deviation on some responses. In addition, there were significant missing responses to some
questions. Missing responses could be
interpreted to mean “zero” in questions
asking about number of procedures performed, for example, but the reasons for
missing responses in other questions are
unknown and impossible to extract. As
the first such survey in Nebraska to address reducing radiation risk and The
Joint Commission Sentinel Event Alert
on radiation safety, there is no basis for
This survey helped reveal many of the ef-
forts Nebraska hospitals already undergo
to minimize radiation risks to medical
diagnostic imaging patients while maxi-
mizing image quality. It also revealed
how hospitals in the state could do better
and some of the challenges in meeting
these quality goals. The project can serve
as a benchmark for future research into
Nebraska hospitals’ efforts to improve
radiation safety for patients in diagnos-
tic medical imaging departments. Fol-
low-up surveys could report on what’s
been done in Nebraska hospitals since
publication of The Joint Commission
Sentinel Event Alert regarding recom-
mendations for improving radiation
safety. It also can serve as an example for
other states to conduct similar surveys
and learn from the successes, limitations,
and results of this research. In particu-
lar, comparing results from Nebraska to
results in other states, particularly states
with similar rural geography and critical
access hospital ratios, could help provide
benchmarking information for radiolo-
gy managers and radiation safety leaders
in all states involved.
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