Establishing a Radiation Dose Reduction Program

ORLANDO, Fla. - The benefits of a radiation dose reduction program may be obvious - patient safety being the major one. But creating a program can be tough and several obstacles can stand in the way of its success.

“You have to gather a coalition. You have to think of this as a project,” said Jef Williams, MBA, PMP, vice president of Ascendian Healthcare Consulting, speaking this week at the 2012 annual meeting of the AHRA, association of medical imaging management. Set up milestones and dedicate the resources necessary to get it done, he said, adding, “The more formalized it is, the better your chances for being successful.”

The first step, Williams said, is establishing a sense of urgency in the organization, and ensuring leadership understand the need for such a program. The initiative starts with department staff, engaging the radiologists and then expanding to the entire hospital. It helps to find a champion for the program, he said, such as the chief of radiology or the CMIO, who believes in the program’s value.

Next, establish a governance structure, he said, which should include leadership from the radiology department, technologists, compliance, clinicians, administrators and technology staff. Clinical leadership can be the hardest to engage, Williams said. It’s not a task that’s reimbursed, the return on investment isn’t clear (if there even is any), and often clinicians aren’t fully aware of the need to reduce radiation dose.

Here’s where radiologists and imaging administrators can really drive the cause. “As leaders we have an imperative to tell the story,” Williams said. “This also gets us in a position of being at the forefront of the thought leadership of our organization.”

Radiologists have an opportunity here to re-engage with the health care facility leadership. “Radiologists, it’s time to get back to doing what you were trained to do: being a consultative physician to other physicians, getting out there and training and providing decision support,” Williams said. “What will make it succeed or fail is getting them back engaged.”

For good measure, Williams outlined a few added benefits of a dose reduction program:

• It’s a new vehicle for communication to engage staff and build relationships.
• It can provide a new career path for a lead technologist who can be trained and given additional responsibility.
• It’s a chance to review policies and procedures and update them where appropriate.
• It can prompt a culture shift in the department, allowing you to address and remedy issues.
• Relationships with the radiologists can be fostered.

Finally, there might be a marketing opportunity there (unless of course, you’re in California and dose reporting is already mandated by law). “Early adopters are going to get the marketing edge,” Williams said. “If you are not in California, you can go out into your community and say, ‘We care. We are monitoring and tracking radiation exposure.’”