AJR: Roman Empire, Facebook offer lessons in pediatric rad dose protection

An array of historical and global approaches provides viable models for developing local policies to promote and improve radiation safety among pediatric patients, according to a commentary published in the May issue of American Journal of Roentgenology.

Marilyn J. Goske, MD, of the department of radiology at Cincinnati Children’s Hospital Medical Center, and colleagues reviewed previous successful practices used to promote large-scale quality improvement projects. Such strategies can be applied in a pediatric radiation protection program, according to the authors.

Goske and colleagues referred to the 2005 book Sic Evenit Radio Ut Componitur: The Small Book About Large System Change in which the author refers to the Roman Empire as an effective example of a large-scale quality improvement program.

Noting that the Roman army was leveraged to communicate and spread change, Goske et al wrote, “[The] army was a ‘social communications network’ akin to social networking sites such as Facebook today.”

The authors emphasized the importance of global collaboration among organizations attempting to affect change in radiation protection, which can minimize redundancy, stretch limited financial resources and share best practices.

The Alliance for Radiation Safety in Pediatric Imaging and other groups have employed web-based social networks to raise awareness about radiation protection. This approach is buttressed by the International Atomic Energy Agency, which supports regional networks and projects that assess imaging appropriateness and radiation dose.

These networks encourage local radiology teams to analyze their practices and compare data with other countries in their regions to spur process improvement.

Meanwhile, the World Health Organization (WHO), through its Radiation and Environmental Health Program, embraces a public health model, wrote Goske et al, which seeks to control and minimize health risk, while maximizing benefit. WHO and collaborating organizations are working to develop evidence-based referral guidelines and methods to facilitate their practice.

Goske and colleagues referred to a final key principle of pediatric radiation safety and wrote, “As we work toward global improvement in radiation protection for children, we must be cautious that we create unified systems that enable the local user to remain focused on improving patient care and services for pediatric patients.” In other words, the patient—and not the project—comes first.