TJC issues alert on diagnostic imaging

The message from the Joint Commission's latest Sentinel Event Alert is clear: reduce radiation exposure from diagnostic procedures.

Over the last 20 years, the typical American has seen exposure to ionizing radiation double. Most of the time, patients are sent for imaging without the prescribing physician having any idea of how much other radiation the patient has been exposed to. Meanwhile, recent studies have increased concerns about the potential health risks associated with too much radiation, particularly in certain populations, like children.

Joint Commission President Mark Chassin, MD, FACP, MPP, MPH, says that there isn't a lot of consensus on how much is too much, and in what time frame. It's prudent, then, to develop strategies to ensure patients get the right imaging with the lowest possible exposure to radiation.

The latest alert makes the following suggestions:

  • Using imaging techniques other than CT, such as ultrasound or magnetic resonance imaging (MRI), and more collaboration between radiologists and referring physicians about the appropriate use of diagnostic imaging.
  • Adherence to the Nuclear Regulatory Commission's ALARA ("as low as reasonably achievable") guidelines, as well as guidelines from the Society of Pediatric Radiology, American College of Radiology, and the Radiological Society of North America for imaging for children and adults, respectively.
  • Assurance by radiologists that the proper dosing protocol is in place for the patient being treated and review of all dosing protocols against the latest evidence either annually or every two years.
  • Expand the radiation safety officer's role to explicitly include patient safety as it relates to radiation and dosing, as well as education on proper dosing and equipment usage for all physicians and technologists who prescribe diagnostic radiation or use diagnostic radiation equipment.
  • Implement centralized quality and safety performance monitoring of all diagnostic imaging equipment that may emit high amounts of radiation cumulatively.

More information is available at the Joint Commission website,