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News Article
US congressmen propose bill to address patient safety loophole in medical imaging
Patient Safety Learning posted a news article in News
Three US congressmen have proposed a bipartisan bill aimed at addressing what they say is a patient safety loophole in medical imaging. Reps. Don Davis, Morgan Griffith and Ben Cline earlier this month introduced the Nuclear Medicine Clarification Act of 2025. Their concern stems from the issue of radiopharmaceutical extravasations—medical errors that occur when a radioactive drug is accidentally injected into the tissue rather than a vein. These incidents can cause tissue damage and compromise the procedure, they note. However, since 1980, the Nuclear Regulatory Commission has exempted radiopharmaceutical extravasations from “medical event” reporting requirements, even if they result in dangerous doses. “Patients deserve to have protections and transparency when undergoing treatment for serious health conditions,” Davis said in a statement. “Improving reporting for accidental radiation exposure is long overdue and we must restore the rights of the patients who place their trust in healthcare providers.” Those involved say the bill would ensure transparency and simplify federal rules. The NRC in 2022 accepted a petition to close the loophole and published a draft proposed rule to require reporting of extravasations that result in injury. However, Davis and colleagues claim the proposal is “insufficient and uses a subjective standard to determine whether an event is reportable.” “It is disturbing that in the year 2025 patients can be extravasated with large doses of radiation that affect their imaging or therapy procedure and may have skin and tissue implications. And it is unconscionable that patients are not told, and the NRC is not informed,” Jackson W. Kiser, a radiologist with the Carilion Clinic in Roanoke, Virgina, who has published numerous articles on this topic, said in the announcement. “I am pleased that Congress is stepping in to force the NRC to protect patients.” Read full story Source: Radiology Business, 25 April 2025 Further reading on the hub: National campaign aims to reduce patient harm from infiltration and extravasation Infiltration and Extravasation: A toolkit to improve practice (NIVAS, 20 February 2024) -
News ArticleMinisters have cut millions of pounds of funding for potentially life saving AI cancer technology in England, which cancer experts warn will increase waiting times and could cause more patients to die. Contouring is used in radiotherapy to ensure treatment is as effective and safe as possible. The tumour and normal tissue is “mapped” or contoured on to medical scans, to ensure the radiation targets the cancer while minimising damage to healthy tissues and organs. Normally, this is a slow, manual process that can take doctors between 20 and 150 minutes to complete. AI auto-contouring takes less than five minutes and costs around £10-£15 per patient. Research shows that AI contouring can cut waits for radiotherapy by more than five days for breast cancer patients, up to nine days for prostate cancer patients and three days for lung cancer patients. In May 2024, the Conservative government announced £15.5m over three years to fund AI auto-contouring for all hospitals providing radiotherapy. Work continued on the scheme after the general election, with online webinars and follow-up calls for radiotherapy departments held in September. The 51 trusts offering radiotherapy continued to work on installing the cloud-based technology, with a number using it early, in the belief the funding was secured. But in February, in an email seen by the Guardian, Nicola McCulloch, the deputy director of specialised commissioning at NHS England, said the funding had been cancelled “due to a need to further prioritise limited investment”. There would no longer be a centrally funded programme to support implementation of the technology, she said. The decision means many radiotherapy departments face a return to manual contouring, prompting accusations that the government is ditching digital and going back to analogue cancer care. Analysis by Radiotherapy UK has calculated that removing funding for AI contouring in England will add up to 500,000 extra days to waiting lists for breast, prostate and lung cancer alone and leave each of the 51 trusts with a £300,000 shortfall. The chair of Radiotherapy UK, Prof Pat Price, said: “The government cannot laud the advent of AI in one breath, and allow this to happen. Far from moving from an analogue to digital NHS, when it comes to radiotherapy it feels like the opposite is happening. This wrong-footed decision will exacerbate the impact of severe staff shortages.” The leading oncologist urged ministers to intervene. “Some departments are so short-handed that they’re shutting machines down because no one is there to operate them and nationally, radiotherapy vacancy rates are running at 8%. This investment in AI could have alleviated some of these pressures. Without it, cancer patients will wait longer than necessary for treatment, potentially costing their lives.” Read full story Source: The Guardian, 31 March 2025
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News Article
How systems are managing the radiologist shortage
Patient Safety Learning posted a news article in News
A radiology shortage has been plaguing health systems in the US for a few years and is expected to get worse in coming years — but systems are making changes to reduce its impact. A shortage of up to 42,000 radiologists is expected by 2033. Currently, the radiology technologist vacancy rates are up to 18.1%, compared to 6.2% three years ago. Further complicating the matter, the number of imaging studies has increased by up to 5% per year, but the number of radiology residency positions has increased by only 2%. If current imaging rates remain standard, there will be an estimated 16.9% to 26.9% increase in imaging utilization by 2055. "We (the industry) waited too long to start discussing the shortage," leaders from Evanston, Ill.-based Endeavor Health told Becker's. "Had we been proactive in understanding this phenomenon, we could have avoided some of the deficit. Now we are in reaction mode and trying to catch up." With America's aging population, many radiologists are also going to be retiring in coming years, with fewer radiologists coming up to replace them. And the challenges for health systems do not end there. "The relatively higher fixed costs smaller private groups bear for billing services, malpractice insurance, benefits, etc. make it increasingly difficult to offer competitive wages, so recruitment and retention in a competitive market become challenging," they said. "We have also experienced unplanned increases in teleradiology pricing over the last year, resulting in a negative margin for this volume subset as the reimbursement for most interpretations outweigh the professional fee collections." Read full story Source: Becker's Hospital Review, 5 March 2025 -
News Article
New trial to speed up breast cancer screening for 700,000 women
Patient Safety Learning posted a news article in News
Health secretary Wes Streeting has announced a landmark trial that will harness artificial intelligence to help catch breast cancer cases earlier, potentially helping the tens of thousands of women diagnosed with the disease each year. Nearly 700,000 women through 30 testing sites around the country will take part in the trial, which will use AI to assist radiologists in mammogram screening to identify changes in breast tissue which could be a possible sign of breast cancer. At the moment mammograms require the expertise of two radiologists, but the Department of Health and Social Care said the AI technology will mean only one specialist will be needed to conduct the screening process safely and efficiently. If successful the trial could free up radiologists and other specialists to conduct more testing which could help reduce waiting lists. Read full story Source: The Independent, 4 February 2025 -
News Article
AI does not necessarily lead to more efficiency in clinical practice
Patient Safety Learning posted a news article in News
The use of artificial intelligence (AI) in hospitals and patient care is steadily increasing. Especially in specialist areas with a high proportion of imaging, such as radiology, AI has long been part of everyday clinical practice. However, the question of the extent to which AI actually influences workflows in a clinical setting remains largely unanswered. Researchers at the University Hospital Bonn (UKB) and the University of Bonn have therefore conducted a comprehensive analysis of existing studies on the effect of AI. They were able to show that AI does not automatically lead to an acceleration of work processes. Their results have now been published in the journal npj Digital Medicine. Although AI is often seen as a solution for handling routine tasks such as monitoring patients, documenting care tasks and supporting clinical decisions, the actual effects on work processes are unclear. Particularly in data-intensive specialties such as genomics, pathology and radiology, where AI is already being used to recognise patterns in large amounts of data and prioritise cases, there is a lack of reliable data on efficiency gains. "We wanted to find out to what extent AI solutions actually improve efficiency in medical imaging," explains Katharina Wenderott, lead author of the study and a doctoral student at the University of Bonn at the UKB's Institute for Patient Safety (IfPS). "The widespread assumption that AI automatically speeds up work processes often falls short." "Our results make it clear that the use of AI in everyday clinical practice must be considered in a differentiated way," emphasises Prof. Matthias Weigl, Director of the IfPS at the UKB, who also conducts research at the University of Bonn. "Local conditions and individual work processes have a major influence on the success of implementation." Read full story Source: Digital Health News, 18 October 2024 -
News Article
Radiographer-led pathway to improve NG tube safety launched
Patient Safety Learning posted a news article in News
The Society of Radiographers is working alongside other organisations to launch a radiographer-led nasogastric (NG) tube position check pathway. Aimed at reducing misplacement incidents and improving patient safety, the pathway has been developed with Royal College of Radiologists (RCR), the British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and the British Association of Parenteral and Enteral Nutrition (BAPEN). Radiographers will be trained to evaluate and record NG tube placement via X-ray, increasing efficiency and providing a safe consistent structured process. Once trained, radiographers can perform these evaluations autonomously in real-time, reducing delays and providing a safe consistent structured clinical evaluation recorded on the Radiology Information System. NHS sites are being encouraged to pilot this pathway, with support from both SoR and RCR. Trusts and boards need to obtain local governance approval and work with key stakeholders to integrate the pathway into existing clinical workflows. Continuous learning will be supported through local audits, ensuring quality and safety are maintained. Radiologists play a key role in supporting radiographers and are essential for overseeing the implementation of the pathway. Read full story Source: The Society of Radiographers, 26 September 2024 -
Content ArticleThis is the 15th annual clinical radiology census report by The Royal College of Radiologists. The census received a 100% response rate, meaning this report presents a comprehensive picture of the clinical radiology workforce in the UK as it stood in October 2022. Key findings The workforce is not keeping pace with demand for services. In 2022, the clinical radiology workforce grew by just 3%. In comparison, demand for diagnostic activity is rising by over 5% annually, and by around 4% for interventional radiology services. The UK now has a 29% shortfall of clinical radiologists, which will rise to 40% in five years without action. By 2027, an additional 3,365 clinical radiologists will be needed to keep up with demand for services. This will have an inevitable impact on the quality-of-care consultants are able to provide. Only 24% of clinical directors believe they had sufficient radiologists to deliver safe and effective patient care. Interventional radiologists are still limited with the care they can provide. Nearly half (48%) of trusts and health boards have inadequate IR services, and only 1/3 (34%) of clinical directors felt they had enough interventional radiologists to deliver safe and effective patient care. Stress and burnout are increasingly common among healthcare professionals, risking an exodus of experienced staff. 100% of clinical directors (CDs) are concerned about staff morale and burnout in their department. 76% of consultants (WTE) who left in 2022 were under 60. We are seeing increasing trends that the workforce is simply not able to manage the increase in demand for services. 99% of departments were unable to manage their reporting demand without incurring additional costs. Across the UK, health systems spent £223 million on managing excess reporting demand in 2022, equivalent to 2,309 full-time consultant positions. Access the full census report here Related content: The benefits of a nursing led Vascular Access Service Team: A White Paper to outline a standardised structure and approach for the NHS to deliver vascular access services in every hospital (27 June 2022)
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Content ArticleThe Care Quality Commission's (CQC) annual report on their work to enforce the Ionising Radiation (Medical Exposure) Regulations in England has been published. The regulations protect people from the dangers of being accidentally or unintentionally exposed to ionising radiation in a healthcare setting. Errors can happen when healthcare providers use ionising radiation to diagnose or treat people. Healthcare providers must notify CQC about these. The report gives a breakdown of the number and type errors that CQC was notified about between 1 April 2022 and 31 March 2023. The report also presents the key findings from our inspection and enforcement activity in that time. In 2022/23, CQC received 727 notifications of errors: 380 (52%) were from diagnostic imaging departments. 77 (11%) were from nuclear medicine departments. 270 (37%) were from radiotherapy departments. During this period, there were over 43 million diagnostic imaging examinations carried out on NHS patients in England. Of these, around 29 million used ionising radiation. There were also 142,000 episodes of radiotherapy treatment in England. This shows that notifications of errors represent a small proportion of the total examinations and treatment undertaken. Although notifications relate to incidents where there is risk of harm, most do not result in harm to patients. The most common cause of error was when images were requested for the wrong patient. We also found that inadequate checks about the patient’s identity or mistakes by the operator had resulted in errors. For some inspections, we made recommendations to providers to make improvements or took enforcement action in response to non-compliance with the regulations. Areas for improvement included: Ensuring a full set of procedures and guidance that reflects effective clinical practice to support staff when delivering care. More frequent testing of equipment. Maintaining up to date and accurate records for practitioners working in the service.
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News Article
Woman dies after doctors fail to properly read brain tumour scans
Clive Flashman posted a news article in News
Despite regular MRI scans at the Royal Preston Hospital showing that the tumour was growing, May Ashford was not offered surgery until five years later. A woman died unnecessarily after doctors failed to operate soon enough on a growing brain tumour, according to the health complaints service. May Ashford, from Blackpool, was diagnosed with a brain tumour in 2010 after experiencing headaches and seizures. Despite regular MRI scans at the Royal Preston Hospital showing that the tumour was growing, she was not offered surgery until five years later. An investigation by the Parliamentary and Health Service Ombudsman (PHSO) said the treatment was too late as medical staff had failed to monitor the scan results properly. Medical experts said Mrs Ashford should have been operated on at least three years earlier, before the tumour had time to grow and affect the surrounding area of the brain. She tragically died aged 71 from a stroke following surgery. Link to full article here -
Content ArticleExposure to ionising radiation during image guided procedures has been associated with a higher incidence of breast cancer in female healthcare workers. Lead or lead equivalent gowns are used to reduce radiation exposure during image guided procedures, but studies have shown that current gowns provide inadequate protection to breast tissue as they leave the upper outer quadrant and axilla exposed. Isobel Pilkington and colleagues discuss the risk and the steps that must be taken to ensure full protection of breast tissue in this BMJ Editorial.
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News Article
Patients exposed to excess radiation by out-of-date radiology device
Patient Safety Learning posted a news article in News
Patients are being exposed to radiation doses at the “upper limit of safe” because a hospital is relying on a radiology machine three years after its “end of life” with a substandard second-hand part. The risk was revealed in board papers from Medway Foundation Trust, in Kent, among several other serious problems linked to outdated equipment. Recent board papers said the machine was necessary for maintaining the trust’s interventional radiology service which includes being on-call 24/7. It said: “Owing to the age of the machine we are experiencing a growing number of faults and breakdowns and due to its age no new parts are available. “At present a second hand tube has been installed to replace the existing faulty equipment.” But the papers went on to say the second-hand part has a defect “causing serious issues with the imaging [which] has the potential to increase imaging acquisitions required which will increase patient radiation dose and lengthen the procedure time”. A business case for a new machine described current radiation doses as “within the upper limit of safe”. The trust indicated “mitigations” are in place, including additional reviews of patients who use it. Read full story (paywalled) Source: HSJ, 11 March 2024 -
Event
SEIPS in radiology
Sam posted an event in Community Calendar
untilThe Patient Safety Incident Response Framework (PSIRF) encourages investigations across the NHS to apply SEIPS. This 3 hour masterclass will focus upon using SEIPS in radiology. The SEIPS trainer Dr Dawn Benson has extensive experience of using and teaching SEIPS, as a Human Factors tool, in health and social care safety investigation. She will be joined in these masterclass sessions by clinical subject experts. Register -
EventuntilThe Faculty of Clinical Radiology has developed guidance on the duty of candour with the aim of providing radiologists with guidance and real-world examples on the implementation of the duty of candour. The document recognises the unique circumstances faced by radiologists and all who work in imaging. It is not possible to provide guidance for every situation, but the aim is to provide an approach which will help colleagues navigate an unfamiliar process in the best possible way for our patients and the professionals who care for them. The Royal College of Radiologists is hosting a webinar to discuss this new guidance and answer any queries. Please submit any questions in advance to [email protected] by Friday 24th June to ensure we are able to answer as many as possible. Register for the webinar
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News ArticleThe Health Information and Quality Authority (HIQA) has today published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year.The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement.John Tuffy, Regional Manager for Ionising Radiation, said “The overall findings of our report indicate that the use of radiation in medicine in Ireland is generally quite safe for patients. The incidents which were reported to HIQA during 2019 involved relatively low radiation doses which posed limited risk to service users. However, there have been radiation incidents reported internationally which resulted in severe detrimental effects to patients so ongoing vigilance and attention is required." John Tuffy, continued “As the regulator of medical exposures, HIQA has a key role in the receipt and evaluation of notifications received. While a significant event is unwanted, reporting is a key demonstrator of a positive patient safety culture. A lack of reporting does not necessarily demonstrate an absence of risk. Reporting is important, not only to ensure an undertaking is compliant but because it improves general patient safety in a service and can minimise the probability of future preventative events occurring.” Read full story Source: HIQA, 9 September 2020
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Content ArticleThis report shares findings from complaints made to Parliamentary and Health Service Ombudsman (PHSO) about failings in imaging in the NHS. The majority of these complaints involve people who had cancer at the time they used imaging services. Through highlighting these complaints, the PHSO’s objective is to support NHS services to improve. It suggests that failings in imaging services can only be addressed and learned from through collaboration across clinical specialties, looking at the whole imaging journey and its intersections as part of the patient’s care pathway. Findings The PHSO analysed 25 complaints relating to failings in the imaging journey since 2013. Most concluded between 2018 and 2020. This report focuses on four key findings they have seen in their casework Failure to follow national guidelines on reporting unexpected imaging findings. Failure to act on important unexpected findings. Delays in reporting imaging findings. Failure to learn from past mistakes. Recommendations For the system as a whole: Recommendations from previous work related to imaging must be implemented as a priority (referring to previous reports by the Healthcare Safety Investigation Branch, Care Quality Commission and the Independent Review of Diagnostic Services). Digital infrastructure must now be treated as a patient safety issue. Department of Health and Social Care and NHS England and NHS Improvement should ensure there is national guidance on the roles and responsibilities of clinicians, and expected timeframes, at each stage of the imaging journey. Department of Health and Social Care and NHS England and NHS Improvement should write to the Health and Social Care Select Committee and the Public Administration and Constitutional Affairs Committee by the end of March 2022. For imaging services specifically: All NHS-funded providers that have a radiology service should ensure staff working in those services have sufficient allocated time in their job plans for meaningful learning and reflection. Clinical directors and senior managers of NHS-funded radiology services should triangulate the learning from across their departments on a regular basis. The Royal College of Radiologists should review existing guidance on reporting unexpected findings and peer review of radiological reports to learn from the findings of PHSO’s casework.
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Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings. In recent years there has been an ongoing growth in demand for radiology services, especially MRI and CT. This pattern of growth is likely to continue as radiology is being used earlier and more widely in diagnostic pathways. This report recommends several measures aimed at maximising existing capacity and expanding services, including: reducing outpatient non-attendance by ensuring imaging can be arranged to suit the patient, through online booking and extended hours. opening day case units or beds for patients having interventional radiology procedures, to help prevent delays and hospital-acquired infections, and free up beds elsewhere. delivering faster results by increasing the amount of reporting carried out at home by radiologists and reporting radiographers. reducing the stress of delays by using artificial intelligence (AI) tools to support scheduling and prioritisation. Watch a short video summary of the report
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Content ArticleThe Healthcare Safety Investigation Branch (HSIB) identified a patient safety risk caused by delays in diagnosing lung cancer. Lung cancer is the third most common cancer diagnosed in England, but accounts for the most deaths. Two-thirds of patients with lung cancer are diagnosed at an advanced stage of the disease when curative treatment is no longer possible, a fact which is reflected in some of the lowest five-year survival rates in Europe. Chest X-ray is the first test used to assess for lung cancer, but about 20% of lung cancers will be missed on X-rays. This results in delayed diagnosis that will potentially affect a patient’s prognosis. The HSIB investigation reviewed the experience of a patient who saw their GP multiple times and had three chest X-rays where the possible cancer was not identified. This resulted in an eight-month delay in diagnosis and potentially limited the patient’s treatment options. The investigation: sought to understand the context and contributory factors influencing a delay in lung cancer diagnosis in a patient repeatedly attending primary care with non-specific symptoms. identified the systemic factors that help or hinder the detection of lung cancer on chest X-rays. considered the utility of chest X-ray to assess for lung cancer in symptomatic patients being seen in primary care. identified the implications of the findings for mitigating the risk of delayed diagnosis of lung cancer. Safety recommendations HSIB recommends that NHS England and NHS Improvement work with research partners to explore options for commissioning research to address whether low-dose computed tomography (CT) is clinically- and cost-effective for the diagnosis of lung cancer in symptomatic patients seen in primary care compared to chest X-ray. HSIB recommends that the National Institute for Health and Care Excellence (NICE) reviews its current safety netting advice to healthcare professionals with respect to the investigation of possible lung cancer. The wording of the advice should be amended as required to make it clearer what should be offered to patients with ongoing, unexplained symptoms who have had a negative chest X-ray. HSIB recommends that NHSX, in collaboration with relevant stakeholders such as The Royal College of Radiologists and The Society and College of Radiographers, develops guidance to support independent benchmarking and validation of artificial intelligence algorithms for the identification of lung diseases such as cancer.
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Content ArticleDiagnostic errors have a negative impact on patient treatment and cost healthcare systems a large amount in wasted resources. This paper published by the Deeble Institute for Health Policy Research looks at diagnostic errors related to medical imaging in Australian public healthcare. It also looks at health policies that have been used internationally to improve the use of diagnostic imaging and reduce the consequences of diagnostic errors. The authors recommend: implementing a national strategy in Australia to identify and prevent diagnostic errors analysing medical indemnity claims to help measure the incidence and consequences of diagnostic errors.
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Content ArticleIn September 2015, the Institute of Medicine (IOM) issued the report “Improving Diagnosis in Health Care,” which focused on the underappreciated problem of diagnostic error in medicine. This report builds on the IOM’s 2000 landmark report, “To Err is Human”, which specifically highlighted opportunities for improvement in diagnostically focused fields, such as radiology and pathology. One of the major recommendations of the report is that “health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance”. Notably, the report emphasises the ineffectiveness of traditional approaches to evaluating medical error that focus on identifying individuals’ errors. In this article published in Radiology, Larson and colleagues review the recommendations set forth by the recent IOM report, discuss the science and theory that underlie several of those recommendations, and assess how well they fit with the current dominant approach to peer review. They also offer an alternative approach to peer review: peer feedback, learning, and improvement (or more succinctly, “peer learning”), which they believe is better aligned with the principles promoted by the IOM.
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Content ArticleSince January 2019, the Health Information and Quality Authority (HIQA) has been the competent authority for regulating medical exposure to ionising radiation in Ireland and receives incident notifications of significant events arising from accidental or unintended medical exposures. As part of its role, HIQA is responsible for sharing lessons learned from significant events. HIQA has published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. This report provides an overview of the findings from these notifications and aims to share learnings from the investigations of these incidents. Findings In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year. The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement. A varied approach to patient safety was evident on review of the corrective measures applied following the occurrence of a significant event. High efficacy corrective measures such as forcing functions, which can eliminate risk, were evident. However, in some cases, the corrective measures put in place to prevent recurrence were limited to low efficacy strategies such as re-education of staff. Undertakings should consider the risk management strategies applied to incident investigations and corrective measures to ensure they are robust and help prevent errors from reoccurring rather than punish. Overall, many of the investigation reports received by HIQA were comprehensive and showed systems based approaches to reviewing incidents. Some, however, focused on human error in isolation, without consideration of human error as a symptom of system weaknesses. Undertakings should ensure a just culture is in place where individuals feel free to report errors, assured that the response will focus on what happened, rather than who failed. This was not always evident in reports received by HIQA. Finally, it is noted that radiation incidents reported to HIQA in 2019 have involved relatively low radiation doses with limited risk to service users. The findings in this report indicate that overall the use of radiation in medicine in Ireland is generally quite safe for patients. However, radiation incidents have been reported internationally with severe detrimental effects to service users. The potential for such serious adverse events highlights the need for ongoing vigilance in relation to radiation protection and the necessity of reporting and learning frameworks. It is hoped that areas of improvement noted in this report would help reduce the likelihood of such events and drive quality improvements in safety mechanisms for medical exposures in Ireland.
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Content ArticleThe Royal Society of Medicine (RSM) has exclusive interviews from leading figures in healthcare on their website, these podcasts focus on a variety of topics within medicine and healthcare, covering everything from mental health and paediatric care to the medical workforce crisis and patient safety. In this episode, Kaji Sritharan talks to Dr Dominic King, Health Lead of DeepMind about the role of Artificial Intelligence and the development and introduction of Digital Technologies into the NHS.
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Content ArticleThe use of checklists can help to prevent incidents and should be part of a culture of patient safety. This guidance set out by the Royal College of Radiologists highlights key considerations when writing and implementing safety checklists.
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Content ArticleThe complexity of Magnetic Resonance Imaging (MRI) and managing the many related safety concerns and interpersonal interactions makes being an MRI practitioner a rewarding but demanding occupation. MRI is an evolving technology. The depth of knowledge required to undertake the many tasks and checks to ensure that work is performed safely and efficiently takes time to acquire and must match the pace of technological progress. The aim of this resource is to provide a workplace tool that helps MRI practitioners to keep current with best practices, assisting them in easily finding and noting essential MRI safety and operational information. This handbook also includes suggestions of the types of content to consider when developing standard operating procedures. Emphasis is placed on the development and use of checklists to improve safety management. The importance of following regulatory guidance and advice from professional bodies is highlighted with the content aimed predominantly at those who follow MHRA MRI safety recommendations. The range of topics covered has been informed by an extensive network of reviewers working in the field of MRI. Unique templates enable the logging of protocols and equipment details while providing prompts for action to assist clinical practice. The variety of material reflects some of the responsibilities, competencies, skills and resilience required by MRI practitioners to do their job. Key features include: Content shaped by a network of experts Customised templates for making technical notes and information: safety checklists, scanning protocols, dealing with emergencies, dealing with implants, contacts, equipment, labelling items for conditions of use, coil considerations, infection control, contrast considerations, pulse sequences, modes of operation, anaesthetic pathways, artefacts, CPD, operational and quality assurance processes, and accountability Space to add your own notes Points to consider regarding patients: screening, positioning, heating, hearing, implants, consent, and communication QR codes to access scanner and contrast manufacturers’ websites, including cross-vendor pulse sequence information and MHRA safety guidance Links to safety guidance and additional MRI resources Weight and height charts. All contained within MR Safe non-ferrous binding
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Content Article
Radiation safety culture in health care encompasses every action taken to improve the protection and safety of patients and personnel involved in medical exposure. This report provides a framework to establish, maintain and enhance radiation safety culture in health care. It highlights patterns of organisational and individual thinking and behaviours which define a positive safety culture and provides a set of tools to assess the existing level and quality of radiation safety culture and good practice examples. The publication was developed by the World Health Organization (WHO) jointly with the International Atomic Energy Agency (IAEA), the International Organization for Medical Physics (IOMP) and the International Radiation Protection Association (IRPA). The key messages of the publication are the following: Actions taken to enhance the protection and safety of patients and personnel involved in medical use of radiation represent radiation safety. These actions lead to radiation safety culture when organisational and individual characteristics and attitudes that determine how everyone practices radiation safety are considered and embedded within an organization (e.g., ideas, values, behaviours and customs). Anyone with a safety concern or perceived safety concern should be empowered to raise awareness and resolve the issue before commencing activities. Leadership, management and personal accountability are critical factors in enhancing radiation safety culture, and those involved in radiation safety should prioritize them as such. Understanding the errors affecting patient safety has developed from a simple causal model to one that considers a complex mix of behaviours and interactions influencing the environment and outcome. Implementing the principles of justification and optimization is essential to ensure that radiation used in health care is managed safely. Engagement strategies must be tailored to the diverse groups of stakeholders contributing to radiation safety culture. Everyone in the diverse groups of stakeholders is responsible for assuring a strong radiation safety culture in health care aiming that patients are imaged and treated correctly. Communication, education and training are considered essential for establishing and maintaining radiation safety culture. There needs to be consistent and coordinated understanding of radiation safety culture among the many stakeholders within health care, which acknowledges the varying perceptions. Everyone can participate in strengthening safety culture. There are international, national and local initiatives to help health care providers improve radiation safety. A combination of optimal tools is required to establish and maintain radiation safety culture. This includes standards and regulations, policies and procedures, education and training, audit activities, communication strategies, reporting and learning systems, checklists, verification procedures, time-out procedures as well as technical developments. A positive safety culture can be defined by ten traits: leadership responsibility, individual responsibility, continuous learning, effective safety communication, respectful work environment, problem identification and resolution, environment for raising concerns, decision-making, questioning attitude and work processes. Good practices to improve safety culture shared by radiation health care providers can be adopted/adapted around the world. Existing frameworks proposing assessment tools and performance indicators can be adopted and adapted to the local context to assess level and quality of radiation safety culture. Related reading Raising awareness and protecting staff from ionising radiation: an interview with Katie Hurst -
Content ArticleThe Royal College of Radiologists (RCR) have published their 2023 clinical radiology and clinical oncology workforce census reports. These reveal dangerous shortages of doctors essential in the diagnosis and treatment of cancer, and other conditions including stroke. The reports show growing delays for patients trying to access critical NHS services: Nearly half of cancer centres reported weekly delays in patients accessing treatment in 2023, with over 8 in 10 cancer leaders (85%) expressing concern that workforce shortages were impacting patient safety. Almost all (97%) radiology leaders say that workforce shortages caused delays and backlogs. These delays are the direct result of severe workforce shortages, due to demand for services outstripping consultant growth. Across the UK: There is a 30% shortfall of clinical radiology consultants (1,962 doctors). Without further action this shortfall is forecasted to increase to 40% (3,670 doctors) by 2028. In 2023, while the clinical radiology workforce grew by 6%, demand for CT and MRI reporting surged by 11%. There is a 15% shortfall of clinical oncology consultants (185 doctors). Without further action this shortfall is forecasted to increase to 21% (325 doctors) by 2028. In 2023, the number of chemotherapy appointments rose by 6-8% but the consultant workforce only grew by 3.5%. As a result of these shortfalls: The NHS spent £276 million on outsourcing, insourcing and ad-hoc locums to manage excess reporting demand– the highest on record. We could fund 2,690 consultant salaries with this money, more than the original shortfall in professionals. Patients are facing unacceptable delays in receiving a diagnosis and starting lifesaving treatments, putting better outcomes at risk. With a 100% response rate from clinical directors and cancer heads of service, this data provides an authoritative snapshot of the workforce and the impact of staff shortages in these critical areas. The time for action is now. The Royal College of Radiologists are calling for a three-point plan to address these dangerous workforce shortages; to recruit, train and retain clinical radiologists and clinical oncologists. This plan includes a series of targeted recommendations for the government and NHS in each nation to integrate into the next iteration of their workforce plan.
