Reducing Variability of Radiation Dose in CT: The New Frontier in Patient Safety |
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| Institution: | 1. Department of Radiology, Division of Pediatric Radiology, Children’s Hospital of Montefiore Medical Center, Bronx, New York;2. Department of Pediatrics, Division of Neonatology Children’s Hospital of Montefiore Medical Center, Bronx, New York;3. Department of Pediatrics, Children’s Hospital of Montefiore Medical Center, Bronx, New York;4. Department of Radiology, Division of Neonatology, Jacobi Medical Center, Bronx, New York;1. Department of Radiation Oncology, West Virginia University, Morgantown, West Virginia;2. Department of Radiation Oncology, Loyola University, Chicago, Illinois;3. Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;1. Division of Interventional Radiology, Rush University Medical Center, Chicago, Illinois;2. Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas;3. Department of Radiology, Northwestern University, Chicago, Illinois;1. Department of Radiology, University of Washington, Seattle, Washington;2. Department of Medicine, University of Washington, Seattle, Washington;3. UW Medicine Center for Scholarship in Patient Care Quality and Safety, University of Washington, Seattle, Washington;4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania;5. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;6. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;7. Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania;1. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts;2. Deposit Products Group, Wells Fargo, San Francisco, California |
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| Abstract: | PurposeAlthough reducing radiation dose in CT examinations is an important goal, also important in the management of radiation dose is ensuring consistency of dose administered for a given type of examination. We have implemented an approach to reducing variance in CT radiation dose by standardizing protocols and implementing software that decreases variance.MethodsA multifaceted approach to reducing variance in CT radiation dose was utilized: (1) establishment of the Radiation Dose Optimization Committee, (2) standardization of protocols, and (3) implementation of scanner software. Two periods of data were collected: pre-intervention (January 1, 2013, to July 31, 2014) and postintervention (January 1, 2016, to December 31, 2016). The period from August 1, 2014, to December 31, 2015, represented the time the major interventions were performed.ResultsThe average radiation dose for all CT exams performed during the pre-intervention period (n = 39,314) was 22.3 CTDIvol with an SD of 17.0. The average radiation dose for all CT exams performed during the postintervention period (n = 49,863) was 13.6 CTDIvol with an SD of 9.01. The postintervention variance was significantly decreased (P < .0001).ConclusionsA significant decrease in the variability of our network CT radiation dose was achieved as a result of a combination of standardizing protocols across the network and implementation of advanced software that effectively managed radiation dose, all overseen by the Radiation Dose Optimization Committee. |
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| Keywords: | CT radiation dose variance quality patient safety radiation variability |
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