The Joint Commission is seeking input on nine proposed revisions to ambulatory healthcare standards related to fluoroscopy. Most of the changes fall under the provision of care, treatment and services chapter.
Online or mailed comments will be accepted through April 20. For more information, click here.
Here's what you should know about the proposed revisions.
1. Environment of care chapter: The required performance evaluation of CT imaging equipment for diagnostic computed tomography services would no longer include the assessment of slice thickness accuracy as an imaging metric.
2. Environment of care chapter: The Joint Commission proposed adding a requirement that organizations providing fluoroscopic services have a physicist or health physicist conduct a performance evaluation of fluoroscopic imaging equipment at least annually.
This revision would require evaluation results and recommendations for correcting any problems to be documented. The evaluation would assess nine components, including beam alignment and collimation, tube potential/kilovolt peak accuracy, high-contrast resolution, low-contrast resolution and exposure rate for typical exams.
3. HR chapter: The Joint Commission proposed specifying that "individuals" — rather than "technologists" — who perform diagnostic computed tomography and/or fluoroscopic examinations should participate in annual training related to radiation dose optimization and safe procedures.
4. Leadership chapter: The proposed revisions include a requirement that fluoroscopic service providers designate a radiation safety officer who is responsible for ensuring radiologic services are compliant.
5. Provision of care, treatment, and services chapter: The Joint Commission proposes adding a requirement for documentation of the reference-air kerma, cumulative-air kerma, or kerma-area product in a "retrievable format." For fluoroscopy equipment that doesn't display reference-air kerma, cumulative-air kerma or kerma-area product, fluoroscopy time and number of images obtained would need to be documented in a retrievable format, such as a picture archiving.
6. Provision of care, treatment, and services chapter: An additional revision in this chapter adjusts the wording of a requirement for diagnostic computed tomography and fluoroscopy imaging protocols. It would require protocols to address expected ranges for fluoroscopy times for fluoroscopy equipment that doesn't display reference-air kerma, cumulative-air kerma, or kerma-area product.
7. Provision of care, treatment and services chapter: Organizations must gather input from an interpreting physician, medical physicist and lead imaging technologist during reviews of imaging protocols for diagnostic computed tomography and fluoroscopy. This review and input is currently only stipulated for diagnostic computed tomography.
8. Provision of care, treatment and services chapter: Organizations that provide fluoroscopic services must establish patient follow-up standards to evaluate adverse radiation effects when the reference-air kerma, cumulative-air kerma, kerma-area product or fluoroscopy time exceeded expected ranges.
9. Provision of care, treatment and services chapter: Fluoroscopic service providers must review and analyze incidents where the reference-air kerma, cumulative-air kerma, kerma-area product or fluoroscopy time exceeded expected ranges. For fluoroscopy equipment not designed to display reference-air kerma, cumulative-air kerma or kerma-area product, the organization only needs to review and analyze fluoroscopy times in excess of expected ranges.