EuroSafe Imaging 2020
Performed at one institution, Not applicable, Retrospective, Quality assurance, Radiation safety, Fluoroscopy, Digital radiography, CT, Radioprotection / Radiation dose, Paediatric, Action 4 - Dose management systems
C. Kelly, J. Goracy, I. Delakis, C. Owens
Description of activity and work performed
Our dose monitoring system was configured to receive Radiation Dose Structured Reports either via the Picture Archiving and Communication System (PACS) or directly from modality equipment, depending on clinical workflows. For example, as studies in the catheterization laboratory do not always require pushing images to the hospital PACS, the Radiation Dose Structured Reports were sent directly from the modality equipment to the dose monitoring system upon completion of each study.
All pieces of equipment were assigned unique identifiers. Filters were then applied within the dose monitoring system so that examinations could be grouped according to modality and study description from the Radiation Information System, as shown in Figure 1.
Careful consideration was given to protocol and exam names to ensure correct groupings. In some cases, this required reviewing protocol and exam names with radiology personnel and updating the naming convention.
The dose monitoring system was also configured so that if an examination/exposure dose exceeded any of the National Diagnostic Reference Levels (Figure 2) by 10%, medical physics was notified to investigate. Where National Diagnostic Reference Levels were not available, reference to the European Pediatric Diagnostic Reference Levels was made .
Alerts were initially investigated by medical physics and then escalated to clinical teams, radiographers and radiologists. Each investigation was recorded so that trends, and therefore areas for improvement, were identified.