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Joint Commission MRI Surveys
What It's Been & What It's Likely To Be.
By Robert Junk, AIA, AHRA and Tobias Gilk
We recently received a call from a university that was terribly proud of their brand new MRI and wanted to coax us into writing a feature about their installation. Unfortunately, the ten-thousand-and-somethingth MRI, in and of itself, isn’t a very captivating story. MRI equipment has become widespread enough that it is now an expected part of conventional clinical care. So how is it that equipment that is almost ubiquitous in US healthcare and yet still trumpeted by public relations officials and, most recently, the American Cancer Society (which called for an additional 1.4 million annual MRIs for breast cancer screening) can be almost completely invisible during Joint Commission surveys?
For the entire brief history of clinical MRI, Joint Commission member imaging facilities have been subject to surveys and investigations. What have these surveys historically reviewed in the MRI suite? Often the surveyor is looking at two aspects of safety and delivery of care: operations and physical safety.
Operationally, it’s just the luck of the draw and depends largely on the randomness of whether or not they shadow a patient who comes to MR. If they do, you can be expected to be asked about the Joint Commission’s hot-button issues of today: Are the physician orders for each contrast administration? Has a medication reconciliation been completed for the patient? Are all drawn and dosed medicines appropriately labeled? Has the pharmacy prepared and prescribed dilutions for packaged contrast media?
For the most part, reports of recent surveys in the MR suite don’t indicate any Joint Commission interest in physical or clinical screenings (including screening for renal function contraindications for Gadolinium based contrast agents). Occasionally, there may be a question about code-readiness, but not always.
From the physical safety standpoint, there has been only one issue that receives regular surveyor attention in the MRI suite and that is a non-magnetic fire extinguisher. No questions about the magnetic properties of the 10,000 other items in and around the MRI suite or whether patient monitoring or treatment devices are approved for use in the magnet room. No check of provisions in support of interventional applications. No questions about staff safety training or device screening. Just the fire extinguisher.
When you consider the extreme detail into which Joint Commission surveys penetrate in other areas of care, many contend that MRI has largely been given a ‘free ride’ with regard to regular Joint Commission surveys. Some suspect that the years of casual surveys of MRI facilities are coming to a close.
The Joint Commission has received reports of accidents at accredited facilities that are raising concerns about how effectively MRI safety procedures are being implemented. When combined with recent reports from both Canadian and UK health authorities on the wide variation in the implementation of MRI safety principles, and the near-doubling of MRI accidents reported to the FDA for the 12-month period ending mid-2006, it’s not surprising that the Joint Commission would be taking a much closer look at the safety of patients and staff in the MRI suites of accredited facilities.
But what are tomorrow’s hot-button issues inside the MRI suite for the Joint Commission? Reports of a forthcoming Sentinel Event Alert and a recent article published in the Joint Commission’s Perspectives on Patient Safety newsletter may give us a good idea.
In next month’s issue of the MRI Newsletter, part II of this article will identify the MRI safety issues that are likely to become much more important to Joint Commission surveys in the months ahead and provide a preparatory check-list for MRI facilities to help make certain that crucial safety issues in the MRI suite have been appropriately addressed.
You're reading the MRI Newsletter, which means you're plugged-in to the industry's leading source for information on MRI suite safety and design. Contact Robert Junk, AIA or Tobias Gilk for information on how we can help you develop your next MRI project.
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