What is risk management?

The better question to ask is, where is there risk in the work place? How does one prevent an accident from occurring? Are there short term and long term issues that one must look at to better assess risk? The appropriate application of risk assessment should result in the improvement of the quality of patient care.

Now let’s think about where there is risk in a nuclear medicine. In an attempt to answer these questions I have done a little “brainstorming” by myself and come up with the following answers. As we go over this I want you to add to this list

Whole body contouring doesn’t contour
Collimator is not attached correctly
Equipment not registered with the FDA
There is a dark hole in my AM flood
Patient falls off the imaging table
Inappropriate transferring of the patient
Cardiac arrest in the stress lab
Patient falls in the hallway
Mis-administration – Diagnostic vs. therapeutic. What’s the difference?
Hot lab issues

Sulfur colloid was a cooking in the hot lab and the vial just exploded
Putting the wrong label on a radiopharmaceutical vial resulting in the mis-administration of three bone patients before it was caught
Gee, I thought it was μCi that I was looking at on the dose calibrator, but it was mCi
What happen to that 50 μCi57Co point source? Was it still attached to the patient when he/she left the department?
Technologist issues

Your badges (hand and whole body) are above the ALARA level II this month
Why didn’t you hand in your badges from last month?
Acquiring data under the wrong name
BioAssay is pass the trigger level
Your hands are always contaminated by the end of the day
I thought I had the heart on the acquisition, but gee it was gal bladder
I know the PM on that equipment is past due
Physician issues

Doctor never palpates the thyroid patient
Doesn’t play an active role in the department
Receives poor history for a study and mis-diagnosis the exam
Faulty correction matrix puts holes into a liver scan
Equipment failure
Patient safety issues

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