VA recommends improvements for MRI safety

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MRI safety in Veterans Health Administration facilities is generally strong, but the VA Office of the Inspector General has recommended important areas for improvement.

Initiated by a 2008 incident in which a patient’s panic button was inoperable, forcing him to crawl out of the MRI scanner for help in a hospital that had not performed routine maintenance checks, on Jan. 26 the VA Administration Office of Inspector General (VA OIG) released a report titled "Combined Assessment Program Summary Report Evaluation of Magnetic Resonance Imaging Safety in Veterans Health Administration Facilities.” The OIG evaluated 50 MRI suites in 43 facilities for safety, training, patient screening and risk assessment.

Overall, the report concluded that “VHA facilities had recognized the importance of safety in the MRI suites and had implemented adequate policies and procedures.” Nevertheless, OIG “identified four areas where compliance with MRI safety requirements and guidelines needs to improve,” and outlined a list of recommendations for the Under Secretary of Health.

With 72 percent of employees in their positions for fewer than two years and 89 percent for more than two years having received training, OIG recommended MRI safety training at operator orientation and annually to ensure greater preparedness.

The office also found that despite strong compliance with American College of Radiology (ACR) guidelines for screening and consent in patients with contraindications to MRI, administration and documentation of consent remained near 50 percent in this group. OIG recommended stronger compliance and documentation, while noting that the “13 facilities that did not retain screening forms as part of the medical record are vulnerable in situations where a known patient returns for an emergent MRI and is unable to answer questions.”

In addition, OIG recommended stronger call system testing and maintenance, increased completion of risk assessment, more frequent emergency drills and the placement of physical barriers en-suite.

Following the report, the Under Secretary of Health concurred with all four major recommendations and responded with an action plan, which the VA OIG said it will follow up until full compliance is achieved.