The March issue of Anesthesiology, the journal of the American Society of Anesthesiologists (ASA), contains a new Practice Advisory on the safety of anesthesia care in the MRI environment. This new call from the ASA for a heightened level of attention is concurrent with startling growth in the rates of reported MRI accidents. The $43,172 question… Will JCAHO answer?
As I see it, the new ASA MRI Practice Advisory does three things… First, with its rigorous methodology it validates (as if it needed the validation) the best practice standards outlined in the ACR’s Guidance Document for Safe MR Practices. Second, it introduces the concept of levels of care to the MR suite (a la trauma centers or nurseries) that correspond to patient acuity and level of intervention. Third, it lends its voice to the rising chorus of government agencies, professional bodies and individual MRI safety experts that are increasingly alarmed over recent trends in MRI safety.
Now we have the FDA, pointing out frightening growth in MRI accident rates. There’s renewed concern about infection control in the MRI suite. Add to these, Anesthesiologists now expressing concern about safety and practice standards for care of sedated patients receiving MRI exams. This all begs the question, who has the most direct oversight role in patient safety at the point of care? Who is best positioned to respond to these broad, multidisciplinary concerns about MRI safety?
- It would have to be an organization with a broad reach across the healthcare provider spectrum, including both hospital-based providers and outpatient / IDTF’s.
- It would have to be an organization with an existing base of authority including real potential for disciplinary action.
- It would have to be an organization that has the capability of more than promulgating written standards, as there have been many of these on MRI patient safety and yet the accident rates have soared.
- To verify real-world conditions at the provider level, it would have to be an organization with the capability to survey the point of care.
- Ideally, it would be an organization that already had provisions on the books that gave it the authority to act in the specific interests of MRI safety.
Can anyone think of an organization that meets this bill? An organization with authority over multiple provider types (JCAHO)? An organization with national authority as well as enforcement tools (JCAHO)? An organization with the structure to help it promote an educational agenda to raise provider awareness of corrective actions (JCAHO)? An organization that has the capability to survey and verify that contemporary standards of care are being met at the provider level (JCAHO)? An organization that already has established advisories on MRI safety issues that are referenced by its own standards (JCAHO)?
Where can we possible turn to find a single entity with the authority and an interest in preventing accidents and injuries in the MRI suite?
And if we found such an organization or commission, would they be willing to accept such a charge?
When organizations outside of radiology, such as the ASA, step up and confront their part of these multivalent risks, isn’t it encumbent upon the organizations charged with patient safety to do something about the overall picture?
That, my friends, is the $43,172 question.
Tobias Gilk, President & MRI Safety Director Mednovus, Inc. Tobias.Gilk@Mednovus.com www.MEDNOVUS.com
