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Type: Journal article
Title: Where failures occur in the imaging care cycle: Lessons from the radiology events register
Author: Jones, D.
Thomas, M.
Mandel, C.
Grimm, J.
Hannaford, N.
Schultz, T.
Runciman, W.
Citation: Journal of the American College of Radiology, 2010; 7(8):593-602
Publisher: Elsevier
Issue Date: 2010
ISSN: 1546-1440
Statement of
D. Neil Jones, M.J.W. Thomas, Catherine J. Mandel, J. Grimm, N. Hannaford, Timothy J. Schultz and William Runciman
Abstract: Adverse events contribute to significant patient morbidity and mortality on a global scale, and this has been documented in a number of international studies. Despite this, there is limited understanding of medical imaging's involvement in such events. Incident reporting is a key feature of high-reliability organizations because, understandably, it is essential to know where things go wrong and why as the very first step in formulating preventative and corrective strategies. Although anesthesiology has led the way, health care in general has been slow to adopt this technique, and this includes medical imaging. Knowledge as to where medical imaging incidents are initiated and detected, and why, is not well documented or appreciated, although this is critical information in relation to quality improvement. Using an online radiology reporting system, the authors therefore sought to gain further insight and also ascertain where failures are located in the imaging cycle, and whether different incidents sources provide different information. Last, the authors sought to examine the resilience of the imaging system using these incident data.
Keywords: Radiology
patient safety
imaging cycle
incident reporting
Rights: Copyright © 2010 American College of Radiology American College of Radiology. Published by Elsevier Inc.
DOI: 10.1016/j.jacr.2010.03.013
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