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Published on: May 26, 2015
Radiation safety in the cardiac catheterization lab: A time series quality improvement initiative
Wael Abuzeid1, Joseph Abunassar2, Jerome A Leis3
1Schulich Heart Center, Sunnybrook Health Sciences Center, , Canada; Institute for Health Policy, Management and Evaluation (IHPME), University of Toronto, Canada.
Insights
Radiation exposure in cardiac catheterization labs was significantly reduced by 91% using novel software. This advancement enhances safety for interventional cardiologists during PCI procedures.
Area of Science:
- Cardiology
- Medical Physics
- Radiation Safety
Background:
- Interventional cardiologists face high radiation exposure.
- Cardiac catheterization labs lack comprehensive radiation safety systems.
- A study aimed to decrease radiation exposure above 1.5Gy during PCI procedures by 40%.
Purpose of the Study:
- To assess interventions for reducing radiation exposure above 1.5Gy in cardiac catheterization labs.
- To evaluate the effectiveness of educational strategies and new software in radiation dose reduction.
Main Methods:
- A time series study analyzed the impact of interventions on radiation exposure frequency.
- Process measures included collimation, magnification use, and online module completion.
- Balancing measures tracked case volume and fluoroscopy time.
Main Results:
- A novel software system (AlluraClarity©) in a new Phillips lab achieved a 91% reduction in radiation exposure above 1.5Gy (p<0.05).
- Collimation use increased, while magnification use decreased; 62% completed online modules.
- No significant changes were observed in the mean number of cases or mean fluoroscopy time.
Conclusions:
- Novel software implementation was the most effective method for reducing radiation exposure.
- Educational strategies alone had a limited impact on radiation dose reduction.
- The study highlights the potential of advanced technology in improving radiation safety in interventional cardiology.
Background:
Interventional cardiologists have one of the highest annual radiation exposures yet systems of care that promote radiation safety in cardiac catheterization labs are lacking. This study sought to reduce the frequency of radiation exposure, for PCI procedures, above 1.5Gy in labs utilizing a Phillips system at our local institution by 40%, over a 12-month period.
Methods:
We performed a time series study to assess the impact of different interventions on the frequency of radiation exposure above 1.5Gy. Process measures were percent of procedures where collimation and magnification were used and percent of completion of online educational modules. Balancing measures were the mean number of cases performed and mean fluoroscopy time.
Interventions:
Information sessions, online modules, policies and posters were implemented followed by the introduction of a new lab with a novel software (AlluraClarity©) to reduce radiation dose.
Results:
There was a significant reduction (91%, p<0.05) in the frequency of radiation exposure above 1.5Gy after utilizing a novel software (AlluraClarity©) in a new Phillips lab. Process measures of use of collimation (95.0% to 98.0%), use of magnification (20.0% to 14.0%) and completion of online modules (62%) helped track implementation. The mean number of cases performed and mean fluoroscopy time did not change significantly.
Conclusion:
While educational strategies had limited impact on reducing radiation exposure, implementing a novel software system provided the most effective means of reducing radiation exposure.
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