PubMed · 11131579
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L F Johnson. 2000. Machine guarding. Avoiding Russian roulette.. https://pubmed.ncbi.nlm.nih.gov/11131579/
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Despite advances in international cooperation, the application of the safety regulations of different countries remains an important challenge for manufacturers and health care workers in the European Union. Rapid technological development during the last 20 years, and the still controversial nature of certain potential effects of magnetic or electromagnetic fields, make the task particularly difficult for MRI and MRS. As the relevant literature is rather extensive, the present work will limit its goals to four questions: 1) How is MRI and MRS safety regulation managed within the European Union? 2) Concerning direct potential physiological effects, what is presently well known and controlled, and, conversely, what are the remaining open (and often controversial) questions? 3) As metallic implants are probably the main risk in routine MRI, what regulatory strategy is in progress in Europe? 4) As indirect risks related to artifacts must not be underestimated, what European programs have been developed for quality assessment in MRI and MRS? In all of these fields, evidence is provided demonstrating the need for a mutual recognition of common standards for the European Union and the United States.
BACKGROUND: On April 30, 2001, the Cleveland Clinic Foundation and Cleveland Clinic Health System Quality Institute sponsored a 1-day conference focused on technology in patient safety. PATIENT SAFETY-A CALL TO ACTION: Kenneth W. Kizer focused on ten high-priority patient safety strategies identified by the National Quality Forum-including implementing recognized "safe practices", recognizing and dealing with professional misconduct, and supporting efforts to create a nonpunitive environment for health care error reporting. CULTURAL IMPLICATIONS OF INTRODUCING NEW TECHNOLOGY: Randolph A. Miller described a computerized clinician order-entry system used to provide decision support, reduce excess test ordering, introduce cost savings, and meet regulations for inpatient radiology and cardiology tests. USING BAR CODES TO ELIMINATE MEDICATION ERRORS: Jeff Ramirez reported on the Veterans Health Administration's use of bar coding technology for point-of-care validation of medication administration, which has resulted in improvements in response time; the efficiency of the dispensing, delivery, and administration process; and patient care. HOW TO MAKE COMPUTERS TEAM PLAYERS: The knowledge base exists to design computers as team players that expand human expertise and help health care practitioners better create safety. Yet David D. Woods challenged the audience to anticipate the changing shape of iatrogenic risk as a result of increasing dependence on automation in health care. TECHNOLOGY AND MEDICATION SYSTEMS: Mark Neuenschwander spoke about automating various steps within the medication use system, through computerized prescriber order entry and bedside scanning. FUTURE TECHNOLOGICAL POSSIBILITIES: Charles Denham suggested how technology may aid health care professionals in their care of patients, such as in using predictive modeling to identify the risks of therapeutic intervention.