Radiation Safety Demands Legislation, Standards
Although radiation oncology equipment goes through much manufacturer testing, users could be trained better on exactly what “fault” messages mean, Dr. Klein continued.
Inconsistent Error Reporting
Dr. Klein added that there is wide variation among manufacturers in reporting machine malfunctions to all their customers.
Sometimes, malfunctions are reported anecdotally or via Listserv, rather than by direct communication to all users of this equipment, Dr. Klein explained. “It might be better to do overkill communication. Right now, it's just scant and irregular.” In most states, hospitals are not required to report errors with linear accelerators as they occur, he noted.
Dr. Tim R. Williams, chair of the American Society for Radiation Oncology, said that ASTRO's 6-point plan to improve patient safety and quality includes a recommendation to work closely with regulatory authorities to create a national database for the reporting of linear accelerator medical errors. The ASTRO plan also attempts to ensure that radiation therapy technologies from different manufacturers can transfer treatment information seamlessly to help reduce medical errors.
CMS Could Foster Safety
Michael Herman, Ph.D., representing the American Association of Physicists in Medicine, called for rigorous minimum standards for accrediting clinical practices, specifically including the oversight of dose and quality assurance for medical-imaging and radiation therapy technology. He asked that reimbursement from the Centers for Medicare and Medicaid Services be directly tied to such accreditation.
The CMS could also help foster radiation safety by funding residencies for physicists in the field, as it does for physicians, said Dr. Klein. He noted that starting in 2014, the American Board of Radiology will allow only physicists who have completed a residency program to sit for board certification.
John Donahue, vice chairman of the radiology benefits management company Medicalis Inc., suggested that the CMS specify radiation safety among the appropriateness criteria it will test in its pilot program on advanced imaging. MIPPA (Medicare Improvement for Patients and Providers Act of 2008) calls for a 2-year demonstration project to test appropriateness criteria for CT scans and other advanced imaging technology.
The American College of Radiology wants accreditation requirements for advanced imaging centers to be extended to hospitals and all clinical settings that perform advanced imaging and radiation therapy procedures, according to Dr. E. Stephen Amis Jr., former ACR chair.
Under the CARE Act, radiology personnel would be subject to new education, training, and licensing requirements.
Source Joel Johndro/iStockphoto.com
