Medication errors highest in radiology - Um, not so fast say radiologists

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This story may explain that gasp you heard throughout the radiology community yesterday after the United States Pharmacopeia (USP) announced results from a report that claim medication errors occur seven times more often in the radiology department than in any other area of healthcare. This conclusion was drawn by studying medication error information from 2000 to 2004 and published in the organization's 6th annual MEDMARX Data Report.
    
"These errors signal hidden risks for patients-hidden because most people view radiological procedures as routine and may not be aware that high risk medications are being used before, during, and after a radiological procedure," said John P. Santell, RPh, primary author of the report and director of Educational Program Initiatives for the Center for the Advancement of Patient Safety (CAPS) at USP.  "Based on our data, we believe that this is a serious issue and must be addressed for patient safety and quality of care."    
    
From 2000 to 2004, 12 percent of the 2,032 medication errors reported in radiological services resulted in patient harm. According to the organization, this represents seven times the harmful errors reported in the general MEDMARX data during the period. Further bad news for radiology departments shows that their services also seem more likely to result in additional care and, as a result, more resources, USP said.
    
UPS believes that flaws in continuity of care are the leading cause of the medication errors as patients move from physicians' offices to radiological services and back again. This faulty or incomplete communication can lead to instances in which patients are administered the wrong drug, dose, or just not being given a medication at all.
   
Radiology is not taking this report lying down. The American College of Radiology (ACR) for one described the report as "incomplete, inaccurate" and said it could cause needless alarm for patients who could now feel the need to avoid having imaging procedures done as a result of the study.
   
More specifically, context is one thing that ACR feels is substantially missing from the USP claims, stating that of the more than 2.5 billion imaging procedures that took place from 2000-2004, the report only cites 2,030 which represents an error rate of just 0.00008 percent. This rate, ACR states, is 3,700 times better than the lowest hospital-wide medication error rate of 0.3 percent.
   
Among a number of disputes over the report, ACR points out that the USP report also is misleading because it attributes certain things such as cardiac catheterization labs as part of radiology, when in reality less than 1 percent of these procedures is performed by a radiologist. UPS also "lumps many events which may be unrelated to the actual performance of imaging procedures into its analysis," the ACR stated.
   
The Radiological Association of North America (RSNA) also responded but was more low-key. Chair of Radiology at Rush North Shore Medical Center in Skokie, Ill. and RSNA spokesperson Leonard Berlin, MD, said that any report that describes errors should be taken seriously by radiologists and is definitely a concern, but that the medication errors addressed in the USP report "don't relate specifically to radiology, or at least are not under a radiology department's control."
   
Berlin also stated that of course there should always be continuity in patient care, communication should be accurate, and patients should be continually monitored, but these things are broad objectives of healthcare and not just a concern of radiology.