Abstract 16906: Effectiveness of Tracking and Reporting Patient Radiation Exposure
Introduction: Despite the life-saving benefits of fluoroscopic cardiovascular imaging, there is extensive scientific evidence that cumulative radiation exposure from these procedures may raise individuals’ lifetime risk of developing cancer or other health problems. Here we describe and evaluate a radiation exposure (RE) reduction project developed and implemented at Intermountain Healthcare catheterization laboratories (cath lab).
Hypothesis: Measuring and reporting RE at the provider and cath lab level for different cardiovascular imaging procedures such as catheter ablations has the potential to help clinicians manage and reduce cumulative RE.
Methods: In 2011, Intermountain compiled RE, based upon calculating the effective dose (ED) in milliSieverts (mSv) from the measured dose area product (DAP) for electrophysiology studies (EPS) and catheter ablations performed at two Intermountain hospitals. RE variability at the provider and the cath lab level suggested we had an opportunity for improvement. A web-based application was developed for the collection of RE data. Cath lab and provider level RE reports were periodically reviewed during quality improvement meetings. EPS and catheter ablation RE data was combined and a before and after (Sep 2015 – Mar 2016) comparison was performed to evaluate the effectiveness of measuring and reporting RE data.
Results: The baseline average RE among all 1072 EPS and catheter ablation cases at hospital A was 4.6 mSv while the baseline average RE at hospital B was 38.9 msv (n=897). Average RE after periodic review of radiation reports was 2.1 mSv for hospital A (n=310; p < 0.001) and 4.6 mSv for hospital B (n=189; p < 0.001). Variation at the provider level was reduced. The provider average RE reduction was 61%. For example, the average radiation of the provider with the lowest baseline RE went from 2.6 mSv (n=256) to an average of 0.6 mSv in 73 consecutive cases during the comparison period (p < 0.001).
Conclusion: Collection, monitoring and reporting of radiation exposure data is an important component of patient safety and has the potential to reduce radiation exposure of fluoroscopic cardiovascular imaging procedures.
Author Disclosures: D. Lappe: None. S. Allison: None. J. Benuzillo: None. C. Roberts: None. D. Welch: None. S. Taysom: None. K. White: None.
- © 2016 by American Heart Association, Inc.