MRI safety—It’s everyone’s responsibility
Lately, I’ve encountered some interesting “hiccups” relative to MRI safety, particularly, the presumed sanctity of Zone III and Zone IV when it comes down to who can and cannot (or is it should and should not?) enter those spaces without going through a screening process. The question I have revolves mostly around how long a screening is “valid.” Clearly there are folks who are frequently in Zones III & IV, so they’re probably going to be a little more attuned to the specific aims of the screening process (beyond ensuring the safety of everyone involved). But what about folks who are less frequently in the higher risk spaces; perhaps you have an MRI space that is not open 24/7 or even a mobile MRI that stops by on an intermittent basis. How do you make sure that your screening process is capturing 100% of the folks who could be in the space? Is there a scenario in which an unscreened individual could gain entry into Zone II or IV, even accidentally (one would like to think that no one would circumvent the screening process on purpose)? What about contractors, law enforcement, or other folks that go “bump” in the night? How do you fold them into the education process to ensure their safety and well-being? Do you have outpatient MRI facilities in the community—do the local emergency responders know the risks and the importance of screening—and being current relative to the screening (the questions don’t change, but the answers might)?
Compliance frequently starts with your internal policies, so if you say that everyone is screened before moving from Zone II into Zone III and beyond, then there can be no exceptions under any circumstance (unless, of course, you describe those risk-based exceptions in the policy). If you have a fire response team in your organization that would be responding in the event of a fire alarm in the MRI space, have each of those folks been screened? What about security who may have to respond to an agitated person in the MRI suite?
You might have noticed at this point that I have way more questions than answers on this particular topic. The baseline expectations are fairly straightforward, but I think is yet another case of the ease (or lack thereof) in operationalizing an absolute. Absolutes are easy to police as non-compliance (with whatever it is we’re addressing) and are pretty clear to identify when they happen, but you also want to set folks up for success. Maybe do some outreach—have an MRI screening day as part of a safety fair and invite the locals! The more folks familiar with the risks and protective measures in place, the more reliable those protections can be!
About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.