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Radiation dose tracking in computed tomography: Red alerts and feedback. Implementing a radiation dose alert system
C Crowley1, E U Ekpo2, B W Carey3
1Department of Radiology, Cork University Hospital, Wilton, Cork, T12 DC4A, Ireland.
Radiography (London, England : 1995)
|July 23, 2020
Summary
Radiographer feedback on radiation tracking system alerts reduced true dose alerts, though overall alert numbers did not significantly change. Improving workflow is key for better system uptake and effectiveness in radiation dose management.
Area of Science:
- Medical Imaging Physics
- Radiological Safety
- Health Informatics
Background:
- Radiation tracking systems generate alerts for elevated radiation doses.
- Understanding the causes of these alerts is crucial for optimizing patient safety.
- Radiographer input can potentially improve the accuracy and utility of these alerts.
Purpose of the Study:
- To investigate the causes of elevated radiation dose alerts from a tracking system.
- To evaluate the impact of radiographer feedback on the incidence of true (unjustifiable) radiation dose alerts.
- To assess the effectiveness of a feedback tool in a real-world clinical setting.
Main Methods:
- DoseWatch system used to monitor 11,298 CT examinations over two six-month periods.
- Red alerts (dose length product twice the median) were identified and classified as true or false by reviewers.
- Radiographers provided feedback on alert causes during the second period; a Chi-Square test analyzed changes in alert incidence.
Main Results:
- False alerts were commonly attributed to procedural documentation errors (57%) and patient size (43%).
- Radiographer feedback was provided for only 17% of studies.
- While overall alerts didn't significantly decrease, the number of true alerts declined from 7 to 3 (p=0.04).
Conclusions:
- Procedural documentation and patient factors contribute significantly to false radiation dose alerts.
- Implementing a radiographer feedback tool effectively reduced the rate of true dose alerts.
- Low system uptake highlights the need to integrate feedback tools seamlessly into clinical workflows.
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