Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave., M-391, Box 0628, San Francisco, CA 94143-0628, USA.
Acad Radiol. 2013 Jun;20(6):769-72. doi: 10.1016/j.acra.2012.11.005.
Radiation exposure from medical imaging has received increasing attention in recent years. Ongoing calls to report radiation doses received during radiology studies as a means of recording cumulative exposure and identifying rare over-exposures have culminated in the State of California passing a mandatory reporting requirement effective July 1, 2012. Herein we describe a radiology housestaff-led quality improvement project to track radiation dose reporting a full year prior to state reporting mandates using a template-driven reporting system and our results over the first 12 months of its implementation.
Effective July 2011, all radiology trainees were instructed to use a standard computed tomography (CT) report template that included a CT dose measurement derived from dose information routinely displayed on our picture archiving and communication system. Consecutive reports from July 1, 2011, to June 30, 2012, of patients who underwent CT examinations at our institution were then retrospectively reviewed. Compliance of each study with the reporting requirement was assessed based on the presence or absence of a radiation dose statement within the finalized report.
A total of 36,217 eligible consecutive CT reports were identified within the review period. Of these, 91.9% reported the radiation dose for the examination, greatly exceeding the initial goal of 80% compliance with the dose reporting requirement.
Successful reporting of CT radiation doses resulted from template-driven reporting, readily accessible calculation tools to facilitate dose calculation, and minimization of reporting burden on the radiologist a full year prior to state regulatory mandates.
近年来,医学影像学中的辐射暴露问题受到了越来越多的关注。为了记录累积暴露量并发现罕见的过度暴露情况,人们不断呼吁报告放射科研究中接受的辐射剂量,这最终导致加利福尼亚州于 2012 年 7 月 1 日通过了一项强制性报告要求。在此,我们描述了一项由放射科住院医师主导的质量改进项目,该项目使用基于模板的报告系统,在州报告要求之前整整一年开始跟踪辐射剂量报告,并介绍其实施头 12 个月的结果。
自 2011 年 7 月起,所有放射科住院医师都被要求使用标准的计算机断层扫描(CT)报告模板,该模板包括从我们的图像存档和通信系统中常规显示的剂量信息中得出的 CT 剂量测量值。然后回顾性地审查了 2011 年 7 月 1 日至 2012 年 6 月 30 日期间在我院接受 CT 检查的患者的连续报告。根据最终报告中是否存在辐射剂量说明,评估每项研究是否符合报告要求。
在审查期间共确定了 36,217 份符合条件的连续 CT 报告。其中,91.9%的报告报告了检查的辐射剂量,大大超过了最初 80%符合剂量报告要求的目标。
模板驱动的报告、便于剂量计算的便捷获取的计算工具以及在州监管要求之前整整一年减少放射科医生的报告负担,成功实现了 CT 辐射剂量的报告。