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Related Concept Videos

Community Based Intervention01:30

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Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
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Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
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Preventing Harm From Fluoroscopically Guided Interventional Procedures With a Risk-Based Analysis Approach.

Grace N Justinvil1, Edwin M Leidholdt2, Stephen Balter3

  • 1VA National Center for Patient Safety, Ann Arbor, Michigan.

Journal of the American College of Radiology : JACR
|April 30, 2019
PubMed
Summary

This study used Healthcare Failure Mode and Effect Analysis to identify and mitigate safety gaps in high-radiation dose fluoroscopically guided interventional procedures. Five interventions were recommended for implementation to improve patient safety during these complex medical treatments.

Keywords:
Failure mode and effect analysisfluoroscopy safetyformal risk analysisinterventional radiologyradiation dose managementskin injury

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Area of Science:

  • Medical Imaging and Interventional Radiology
  • Patient Safety and Risk Management
  • Health Systems Engineering

Background:

  • Fluoroscopically guided interventional (FGI) procedures offer lower complication rates than surgery for high-risk patients.
  • Radiation-induced tissue injuries can occur with peak skin doses exceeding 3 Gy, manifesting weeks to months postprocedure.
  • Monitoring air kerma for radiation safety remains a challenge in clinical practice.

Purpose of the Study:

  • To identify and mitigate systematic gaps in high-radiation dose FGI procedures within VA and non-VA institutions.
  • To enhance patient safety by addressing challenges in radiation dose monitoring.
  • To evaluate the effectiveness of risk-based analysis in FGI procedures.

Main Methods:

  • A multi-institutional team applied Healthcare Failure Mode and Effect Analysis (HFMEA).
  • HFMEA was utilized on an implantable cardioverter defibrillator lead extraction procedure as a case study.
  • Interventions were devised and prioritized based on feasibility, cost-effectiveness, and clinical impact.

Main Results:

  • Twenty-nine interventions were developed through the HFMEA process.
  • Five high-priority interventions were recommended for immediate implementation or piloting.
  • The study successfully demonstrated the application of formal risk-based analysis techniques.

Conclusions:

  • Formal risk analysis techniques, such as HFMEA, are valuable for improving safety in FGI procedures.
  • The identified high-priority interventions can benefit other facilities performing high-radiation dose procedures.
  • Risk-benefit analyses and safety protocols can be enhanced through systematic risk assessment.