Joint Commission Finalizes New Requirements for CAUTI NPSG

 

 

Proposed Joint Commission NPSG focuses on risks of pediatric CT scans

Radiology experts are split on whether the focus on head and chest scan is a valuable use of resources

A proposed National Patient Safety Goal (NPSG) released by The Joint Commission in February takes aim at judicious use of computed tomography (CT) imaging among pediatric patients, requiring hospitals to follow evidence-based guidelines when considering CTs for minor head trauma.

The proposed standard, released as NPSG.17.01.01, would apply to hospitals, ambulatory care facilities, and critical access hospitals. The Joint Commission accepted comments on the proposed requirement through the end of March.

In its announcement, the accreditor noted that although evidence suggests CT imaging “[may have] stabilized or is declining after a period of increased use,” the proposed standard would bring further attention to the issue and reduce the potential for radiation exposure among pediatric patients.

“An NPSG would spotlight this issue, and would motivate accredited organizations to use evidence-based practices for determining when CT examinations are necessary,” The Joint Commission said in its announcement.

In its rationale for the proposed standard, The Joint Commission argues that because children are more susceptible to ionizing radiation, standardized guidelines would help hospitals “determine when CT examinations are necessary for minor pediatric head trauma and when dual phase CT exams of the head and chest are needed for pediatric patients.”

Under the proposed standard, hospitals would be required to do the following:

• Adopt evidence-based practices for evaluating patients with minor head trauma. The Joint Commission specifically mentions the Pediatric Emergency Care Applied Research Network’s (PECARN) Childhood Head Trauma: A Neuroimaging Decision Rule.
• Implement appropriate use criteria for dual-phase CT examinations of the head and chest.
• Monitor compliance with the previous two requirements.
• Establish goals for compliance and identify steps for improvement.

 

Some radiology experts, such as Alan Schroeder, MD, who until recently was medical director of the pediatric ICU at the Santa Clara Valley Medical Center in San Jose, California, applaud The Joint Commission’s decision to focus on CT imaging, noting that the standard would bring needed attention to the long-standing issue of unnecessary CT scans. (Editor’s note: Prior to publication, Schroeder began a new position as associate division chief for research in pediatric hospital medicine at Stanford Children’s Health in Palo Alto, California.)

“The benefit of it would be not just limiting radiation, but limiting of cost and resource use, and also the potential that abnormalities would be found that don’t wind up benefiting the patient,” he says.

This is an excerpt from the May issue of Patient Safety Monitor. Subscribers can read the rest of the article here. Non-subscribers can find out more about the journal, its benefits, and how to subscribe by clicking here.