Radiology guidelines aim to cut errors

NEW GUIDELINES for radiologists will not eliminate errors but will reduce them as much as possible, the dean of the faculty of radiologists at the Royal College of Surgeons has said.

Dr Risteárd Ó Laoide said the faculty needed to spread the word that errors did happen and the interpretation of images, such as X-rays, was not always black and white.

The launch of the Guidelines for the Implementation of a National Quality Assurance Programme in Radiology followed a number of controversies around the reporting of X-ray results, including at Tallaght Hospital, where a delayed diagnosis resulted in the death of a patient earlier this year. A review there also revealed that almost 58,000 X-rays had never been seen by a consultant radiologist.

The guidelines recommended there should be a clear pathway in all hospitals for communicating “critical, urgent and clinically significant unexpected findings”.

Critical findings, where emergency action was required as soon as possible, may require “vocal communication of results”, the guidelines stated. Less urgent results could be communicated by other mechanisms, including e-mail or fax, or flagged on patient records.

Also recommended was that radiological departments should have “discrepancy meetings” which would examine errors made by radiologists.

Dr Ó Laoide said the errors would be “anonymised” to prevent bias and the cases would be discussed to uncover the underlying problem, what could be learnt and what needed to change “to obviate this error occurring again”.

The department would work with risk management within the hospital and, if there was an impact on a patient, the clinician looking after the patient would be informed.

The guidelines would be rolled out across the State beginning with cancer centres, Dr Ó Laoide added, and it was hoped all cancer centres would adopt them by the end of 2011. They would not eliminate errors completely, he said, but would introduce mechanisms to reduce them.

Tony O’Brien, deputy director of the National Cancer Control Programme, said the guidelines would help to restore confidence in the healthcare system. They would also reduce the necessity for thousands of patients to have their cases reviewed after the discovery of a single error.