Lee Yuan-Hao, Chen Clayton Chi-Chang, Lee San-Kan, Chen Cheng-Yu, Wan Yung-Liang, Guo Wan-Yuo, Cheng Amy, Chan Wing P
Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
BMJ Open. 2016 Sep 20;6(9):e010756. doi: 10.1136/bmjopen-2015-010756.
Variations in radiological examination procedures and patient load lead to variations in standards of care related to patient safety and healthcare quality. To understand the status of safety measures to protect patients undergoing radiological examinations at residency training hospitals in Taiwan, a follow-up survey evaluating the full spectrum of diagnostic radiology procedures was conducted.
Questionnaires covering 12 patient safety-related themes throughout the examination procedures were mailed to the departments of diagnostic radiology with residency training programmes in 19 medical centres (with >500 beds) and 17 smaller local institutions in Taiwan. After receiving the responses, all themes in 2014 were compared between medical centres and local institutions by using χ(2) or 2-sample t-tests.
Radiology Directors or Technology Chiefs of medical centres and local institutions in Taiwan participated in this survey by completing and returning the questionnaires.
The response rates of medical centres and local institutions were 95% and 100%, respectively. As indicated, large medical centres carried out more frequent clinically ordered, radiologist-guided patient education to prepare patients for specific examinations (CT, 28% vs 6%; special procedures, 78% vs 44%) and incident review and analysis (89% vs 47%); however, they required significantly longer access time for MRI examinations (7.00±29.50 vs 3.50±3.50 days), had more yearly incidents of large-volume contrast-medium extravasation (2.75±1.00 vs 1.00±0.75 cases) and blank radiographs (41% vs 8%), lower monthly rates of suboptimal (but interpretable) radiographs (0.00±0.01% vs 0.64±1.84%) and high-risk reminder reporting (0.01±0.16% vs 1.00±1.75%) than local institutions.
Our study elucidates the status of patient safety in diagnostic radiology in Taiwan, thereby providing helpful information to improve patient safety guidelines needed for medical imaging in the future.
放射检查程序和患者数量的差异导致与患者安全和医疗质量相关的护理标准存在差异。为了解台湾住院医师培训医院中接受放射检查患者的安全措施状况，我们进行了一项后续调查，评估了诊断放射学程序的全貌。
涵盖整个检查过程中12个与患者安全相关主题的问卷被邮寄给台湾19家医学中心（床位>500张）和17家较小的地方机构中设有住院医师培训项目的诊断放射科。收到回复后，使用χ(2)检验或两样本t检验对2014年所有主题在医学中心和地方机构之间进行比较。
台湾医学中心和地方机构的放射科主任或技术主管通过填写并返还问卷参与了这项调查。
医学中心和地方机构的回复率分别为95%和100%。结果显示，大型医学中心更频繁地开展临床医嘱下、由放射科医生指导的患者教育，为患者进行特定检查（CT，28%对6%；特殊程序，78%对44%）以及事件审查和分析（89%对47%）；然而，它们的MRI检查等待时间明显更长（7.00±29.50天对3.50±3.50天），每年大容量造影剂外渗（2.75±1.00例对1.00±0.75例）和空白X光片（41%对8%）的事件更多，每月次优（但可解读）X光片（0.00±0.01%对0.64±1.84%）和高风险提醒报告（0.01±0.16%对1.00±1.75%）的发生率低于地方机构。
我们的研究阐明了台湾诊断放射学中患者安全的状况，从而为改进未来医学成像所需的患者安全指南提供了有用信息。
