HIQA Inspections Reveal Compliance Levels of Cork Medical Facilities for Ionising Radiation
Hiqa recently published 17 inspection reports on medical exposure to ionising radiation. These included assessments from five facilities in Cork, both public and private.
Complete DXA Solutions in Mahon was fully compliant with all regulations. Mercy Hospital (MUH) and UPMC Bon Secours each received one mark for substantial compliance but were otherwise fully compliant. Inspectors noted considerable improvements in compliance at MUH compared to the last inspection.
Good practices were observed at UPMC Bon Secours. However, Alliance Medical at CUH reported non-compliance in the area of Procedures while maintaining full compliance in other areas. The regulations require that patient exposure information be included in reports of medical radiological procedures. Inspectors found that this information was missing for CT exams at Alliance Medical. Inspectors were told that a solution was being developed, but no completion date was provided. The provider later confirmed that patient exposure information is now included in all radiological reports.
How does patient exposure information in radiological reports impact healthcare decision-making?
Interview with Dr. Sarah O’Reilly, Radiological Compliance Specialist
Interviewer: Thank you for joining us today, Dr. O’Reilly. Hiqa’s recent inspection reports revealed various compliance levels across facilities in Cork regarding medical exposure to ionising radiation. What is your overall assessment of these findings?
Dr. O’Reilly: Thank you for having me. The inspection reports highlight a significant variation in compliance levels in the facilities assessed. It’s encouraging to see that Complete DXA Solutions in Mahon achieved full compliance, which sets a benchmark for others. However, the findings at other sites, particularly the non-compliances noted at Alliance Medical and Radetal, raise important concerns about patient safety that need to be addressed.
Interviewer: Notably, Mercy Hospital and UPMC Bon Secours received marks for substantial compliance, yet there were improvements observed at Mercy Hospital compared to previous inspections. What does this indicate about the facility’s approach to regulatory compliance?
Dr. O’Reilly: Improvements at Mercy Hospital suggest that the facility is taking the process seriously and actively working on enhancing their protocols and practices. Substantial compliance indicates that while they meet most regulatory standards, there are still areas for improvement. Continuous monitoring and incremental changes are essential to ensure they maintain and advance their compliance status.
Interviewer: Inspectors pointed out missing patient exposure information in CT reports at Alliance Medical. How critical is this information for patient safety and treatment?
Dr. O’Reilly: The inclusion of patient exposure information in radiological reports is crucial as it contributes to informed decision-making for both clinicians and patients. Understanding the levels of exposure helps in assessing risks, especially for repeat procedures. It also aids in maintaining transparency and trust between healthcare providers and patients. The fact that a solution is being developed, while positive, underscores the necessity for timely action; delays in such matters can compromise patient safety.
Interviewer: Radetal’s Cork service was noted for having the lowest compliance. What steps should they take to address the non-compliance issues highlighted in the report?
Dr. O’Reilly: Radetal needs to implement immediate corrective actions based on the feedback from Hiqa. This includes establishing comprehensive protocols for all procedures, especially those related to paediatrics, and enhancing their clinical audit processes. Furthermore, the radiation safety committee must update its terms of reference to reflect current practices and regulations. Regular audits and updates to protocols are essential to ensure ongoing compliance and to foster a culture of safety within the organization.
Interviewer: With these reports made public, what should patients and families take away regarding their safety in medical procedures involving ionising radiation?
Dr. O’Reilly: Patients should feel empowered to ask questions about their exposure during medical procedures. It’s their right to understand the risks and benefits associated with the radiological services they receive. The findings from Hiqa serve as a reminder that while the majority of facilities are striving to comply with regulations, there are still gaps that need attention. Advocacy for transparency and safety from healthcare providers is paramount in ensuring that patient welfare remains the top priority.
Interviewer: Thank you, Dr. O’Reilly, for sharing your insights on this important issue.
Dr. O’Reilly: Thank you for the opportunity to discuss it. It’s critical to keep these conversations ongoing to improve patient safety in radiological practices.
Radetal’s Cork service at CUH had the lowest compliance in the country, with four non-compliance issues, six areas of substantial compliance, and only two fully compliant areas. While written protocols were established for some standard procedures, they did not cover paediatric procedures. Inspectors noted that only one clinical audit had occurred in the past year, and no clinical audit schedule was in place. Concerns arose regarding the referrals process, and the radiation safety committee’s terms of reference were outdated, with no review since 2019.
Due to the identified non-compliances, immediate action was needed to assure Hiqa that these issues would be addressed. The provider assured Hiqa that they had reviewed and updated procedures, documents, and policies, as well as adopted a formal clinical audit strategy.