Building a safety culture | Philips Healthcare

Establishing a safety culture for radiation dose management requires elements such as harmonization across the institution for imaging procedures and protocols, information provided to patients about the risks of radiation exposure, and a common set of expectations regarding safety embodied within each department’s operations.

Why the need for a ‘safety culture’?

Although radiation has been used in healthcare for more than 100 years, recent public events and increased media attention have thrust it into the spotlight. General industry consensus is that radiation must be better controlled. Implementation of a strong safety culture proves commitment.

The challenge

The challenge for most hospitals is twofold. First they must overcome decades of practices, attitudes, beliefs and misconceptions about radiation and the use of X-rays in medical practice. Second, they must acknowledge that diverse departments within the hospital (using X-ray equipment) are not all equally prepared to manage safety needs.

The goal

The goal is to develop a ‘safety culture’ that promotes comprehensiveness, consistency and coordination for safety across all departments – a culture that is willing to hold each department accountable towards meeting the goal.

Establishing a safety culture for radiation dose management requires elements such as harmonization across the institution for imaging procedures and protocols, information provided to patients about the risks of radiation exposure, and a common set of expectations regarding safety embodied within each department’s operations.

Why the need for a ‘safety culture’?

Although radiation has been used in healthcare for more than 100 years, recent public events and increased media attention have thrust it into the spotlight. General industry consensus is that radiation must be better controlled. Implementation of a strong safety culture proves commitment.

The challenge

The challenge for most hospitals is twofold. First they must overcome decades of practices, attitudes, beliefs and misconceptions about radiation and the use of X-rays in medical practice. Second, they must acknowledge that diverse departments within the hospital (using X-ray equipment) are not all equally prepared to manage safety needs.

The goal

The goal is to develop a ‘safety culture’ that promotes comprehensiveness, consistency and coordination for safety across all departments – a culture that is willing to hold each department accountable towards meeting the goal.

Stages of dose management

Where does your hospital fit?

Stage One
Stage One
Little consistency in the management of the sources of radiation, and hence radiation safety

Lack of centralized control of X-ray machine procurement

Lack of consistency in X-ray safety procedures between departments

Confusion over who is responsible for X-ray safety management

Lack of or inadequate staff training

Lack of informed consent

Lack of key performance indicators

Lack of harmonized protocol naming and acquisition parameters

Lack of consistent worker dosimetry badging practices
Stage Two
Stage Two
Accepts responsibility to control radiation exposure and is committed to expending resources

Centralized process for procuring and installing X-ray machines

Top level policies establishing departmental expectations for X-ray safety management

Departments have X-ray safety policies and procedures that are consistent

Departments approach training as an integral component of a high performing organization

Key performance indicators are generated and reviewed by a committee with institutional responsibilities

Naming of procedures, acquisition parameters, consent forms, reporting, etc. are harmonized across institution
Stage Three
Stage Three
Shares attitudes, values, goals, and practices regarding radiation safety reflected by consistent protocols and procedures

All aspects of X-ray safety needs and regulations are integrated in capital budgeting process and build-outs

Physicians order the most appropriate imaging exam for the clinical benefit of the patient

Formal process/committee for reviewing key performance indicators and taking action for improvements

Annual review of policies/procedures/protocols for harmonization and changes made when needed

Ongoing interactive training for all individuals with x-ray safety/radiation safety responsibilities

Measures of staff morale and patient satisfaction with respect to radiation safety are periodically monitored and results used to make system-wide improvements

You can get there from here

To move along the spectrum of radiation dose management (from Stage One to Stage Three), the hospital needs to first perform a critical and comprehensive assessment of how sources of radiation are managed, i.e., their procurement, installation, use, maintenance, and replacement. Common protocols, procedures, etc. must also be identified and complied. Then:

Obtain senior management support – Without their support, efforts to bring all departments to the same table will be difficult – at best.
Involve the proper committees – Key member of the Radiation Safety Committee and the Patient Safety Committee must participate
Identify necessary resources – Assessments, reviews, meetings, etc. cannot happen if resource needs are not identified and approved as part of the planning process.
Implement improvements – The hospital must have a vision of what it wants to achieve and act on those goals.
Measure progress – Progress must be measured using appropriate metrics that will provide accurate results.

Tools that help organize data, provide key performance indicators, and perform analyses are important. The best tool is one that will help institutions gain control over how imaging exams are ordered, monitors institution/ department/machine/ operator performance for comparison against guidelines and standards, and helps identify where improvements can be most effective.

Positive returns

Studies have shown that instituting a safety culture for dose management benefits hospitals by demonstrating to staff and patients the importance they place on their safety and well being which improves morale, employee retention and patient loyalty. An institution that has achieved a safety culture for radiation dose management has:

• Instilled the importance of radiation safety at all levels of staff within the organization
• Created an aligned infrastructure consistent with the culture
• Provided the resources needed to support the infrastructure
• Performed appropriate measures to determine success and is constantly learning and making changes to improve

Building a safety culture
for dose management

Why the need for a ‘safety culture’?

The challenge

The goal

Why the need for a ‘safety culture’?

The challenge

The goal

Stages of dose management

Where does your hospital fit?

You can get there from here

Enable dose management across your organization

Positive returns

More dose management articles and insights

Building a safety culture for dose management

Why the need for a ‘safety culture’?

The challenge

The goal

Why the need for a ‘safety culture’?

The challenge

The goal

Stages of dose management

Where does your hospital fit?

You can get there from here

Enable dose management across your organization

Positive returns

More dose management articles and insights

Building a safety culture
for dose management