From the September 2016 issue of HealthCare Business News magazine
Improved and expanded CT policies and procedures
Putting clear, specific and reasonable policies and procedures in place to codify the CT dose reduction program is an essential part of the successful CT dose optimization program. This action is a critically important one that creates a lasting structure at the facility or facilities, which enables the CT dose optimization program to continue working into the future despite staff turnover. Facilities executing successful CT dose initiatives spend time reviewing their CT policies and procedures, and put a high level of attention into the details of workflow, process, roles and responsibilities.
In some cases, facilities have found that bringing in a third-party operations/technical consultant can be helpful in this particular task, as an outsider may have seen things that work well in similar facilities, or be able to identify pitfalls from their previous experiences. No matter how the institution approaches this process, it tends to take time and some degree of iteration and experimentation before the process is complete. In the minority of facilities that have completed this action, it has been done typically (and I think rightfully) near the end of the implementation phase of the dose optimization program, as creation of high-quality policies and procedures is more likely when staff are fully trained, familiar with the processes and many details have already been worked out in the program.
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The state of CT dose optimization in the U.S. has evolved substantially in the past decade, prompted by greater public and regulatory concern as well as by enhanced health care industry awareness. Administrators, technologists, radiologists and medical physicists are all more cognizant of the need to reduce patient doses while maintaining acceptable image quality. CT equipment manufacturers have improved their hardware and software to enhance dose efficiency and radiation safety. Software vendors have created sophisticated patient dose tracking and analysis products and services.
And many health care facilities have started to build the administrative and technical framework necessary for a successful and ongoing CT dose optimization program. We are still in the early days of this effort. Many CT imaging facilities still have no formal CT dose optimization program, or their program is not yet fully formed in the sense that: all CT staff are properly trained on dose reduction techniques; CT policies and procedures define and describe the operation of the CT dose optimization program; all CT protocols have been dose-optimized; appropriate CT protocol controls are in place; patient CT doses are analyzed to identify outliers, spot trends and compare to external benchmarks; and patient CT doses are reported to stakeholders appropriately and fed back into the dose optimization program, resulting in continual improvement to protocols and processes.