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专题报告: 一只眼睛在MRI安全

Carol Ko, Staff Writer | October 16, 2013
From the October 2013 issue of HealthCare Business News magazine

Another common structural problem West sees is doors that open inward into the room. “A door should never open inward, it should open outward, so that if the magnet quenches, the room doesn’t pressurize and prevent you from opening the door,” he explains.

Though the building code helps mitigate some of the issues around MRI safety, other issues require that operational protocols and standards be enforced within the provider’s department. And for that to happen, MRI suites would need accreditation standards.

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There’s just one problem: none of the accrediting organizations within this modality have specific standards that prevent the most common MRI accidents from occurring. They all have recommendations to help mitigate risk, but they’re not built into the criteria for accreditation.

According to Gilk, it’s a matter of conflict of interest, since accrediting organizations rely on subscriber memberships from providers to keep alive.

“The unspoken concern is, if I’m head of an accrediting organization and I say let’s implement specific accreditation criteria, we will be increasing the burden on our providers,” he says. In other words, there’s widespread fear that such a move would drive dues-paying subscribers into one of the competing organizations.

“There’s a built-in disincentive to take on these standards, which is tragic because we know exactly how these patients are getting injured and we know what the effective preventions are,” says Gilk.

All that said, incremental steps toward change are on the way.

In August of this year, the Joint Commission released draft revisions on diagnostic imaging accreditation requirements that include new safety measures for hospitals using MRI.

But what’s most interesting about the draft is what it leaves off. Last year, we reported that Joint Commission surveyors were beginning to ask for documents verifying MR safety training among technologists along with requiring zone signs.

Curiously enough, neither of those criteria was included in the newly released draft revisions. Instead, the document stresses more stringent restrictions and supervision on access to MRI rooms by MRI-trained staff, and a separate room preceding the MRI suite for everyone not screened by staff — all of which essentially rephrases the ACR fourzone principle widely cited by MRI safety advocates.

The zone signage requirements may have been counterproductive to safety when applied to MRI suites that were not built with those zones in mind. On the other hand, experts agree that verification of safety training would have been a good addition to the document.

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