Robin R Whitebird1, Leif I Solberg2, Philip W Chu3, Rebecca Smith-Bindman4. 1. Professor, Morrison Family College of Health, School of Social Work, University of St Thomas, St Paul, Minnesota. Electronic address: rrwhitebird@stthomas.edu. 2. Senior Advisor and Senior Research Investigator, Health Partners Medical Group, HealthPartners Institute, Minneapolis, Minnesota. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco, California. 4. Director, Radiology Outcomes Research Laboratory, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics and the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.
Abstract
BACKGROUND: Advances in CT have facilitated widespread use of medical imaging while increasing patient lifetime exposure to ionizing radiation. PURPOSE: To describe dose optimization strategies used by health care organizations to optimize radiation dose and image quality. MATERIALS AND METHODS: A qualitative study of semistructured interviews conducted with 26 leaders from 19 health care systems in the United States, Europe, and Japan. Interviews focused on strategies that were used to optimize radiation dose at the organizational level. A directed content analysis approach was used in data analysis. RESULTS: Analysis identified seven organizational strategies used by these leaders for optimizing CT dose: (1) engaging radiologists and technologists, (2) establishing a CT dose committee, (3) managing organizational change, (4) providing leadership and support, (5) monitoring and benchmarking, (6) modifying CT protocols, and (7) changes in equipment and work rules. CONCLUSIONS: Leaders in these health systems engaged in specific strategies to optimize CT dose within their organizations. The strategies address challenges health systems encounter in optimizing CT dose at the organizational level and offer an evolving framework for consideration in dose optimization efforts for enhancing safety and use of medical imaging.
BACKGROUND: Advances in CT have facilitated widespread use of medical imaging while increasing patient lifetime exposure to ionizing radiation. PURPOSE: To describe dose optimization strategies used by health care organizations to optimize radiation dose and image quality. MATERIALS AND METHODS: A qualitative study of semistructured interviews conducted with 26 leaders from 19 health care systems in the United States, Europe, and Japan. Interviews focused on strategies that were used to optimize radiation dose at the organizational level. A directed content analysis approach was used in data analysis. RESULTS: Analysis identified seven organizational strategies used by these leaders for optimizing CT dose: (1) engaging radiologists and technologists, (2) establishing a CT dose committee, (3) managing organizational change, (4) providing leadership and support, (5) monitoring and benchmarking, (6) modifying CT protocols, and (7) changes in equipment and work rules. CONCLUSIONS: Leaders in these health systems engaged in specific strategies to optimize CT dose within their organizations. The strategies address challenges health systems encounter in optimizing CT dose at the organizational level and offer an evolving framework for consideration in dose optimization efforts for enhancing safety and use of medical imaging.
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Authors: Rebecca Smith-Bindman; Philip Chu; Yifei Wang; Robert Chung; Naomi Lopez-Solano; Andrew J Einstein; Leif Solberg; Luisa F Cervantes; Thomas Yellen-Nelson; William Boswell; Bradley N Delman; Phuong-Anh Duong; Allen R Goode; Nima Kasraie; Ryan K Lee; Rebecca Neill; Anokh Pahwa; Pavlina Pike; Jodi Roehm; Sebastian Schindera; Jay Starkey; Saravanabavaan Suntharalingam; Cécile R L P N Jeukens; Diana L Miglioretti Journal: JAMA Intern Med Date: 2020-05-01 Impact factor: 21.873
Authors: Rebecca Smith-Bindman; Yifei Wang; Philip Chu; Robert Chung; Andrew J Einstein; Jonathan Balcombe; Mary Cocker; Marcos Das; Bradley N Delman; Michael Flynn; Robert Gould; Ryan K Lee; Thomas Yellen-Nelson; Sebastian Schindera; Anthony Seibert; Jay Starkey; Saravanabavaan Suntharalingam; Axel Wetter; Joachim E Wildberger; Diana L Miglioretti Journal: BMJ Date: 2019-01-02