Multiple failed organizational and departmental processes may lead to wrong-patient, wrong-procedure, wrong-side, and wrong-site errors in radiology services. Explanations for such errors are linked to similarities in sites, diagnostic studies, and patient names; breakdowns in communication or teamwork; patient and procedure factors; and failed safety systems. Review of events reported to the Pennsylvania Patient Safety Authority in 2009 identified specific processes that exposed patients to potential harm, including order and scheduling inaccuracies, patient misidentification, and inaccurate procedure verification practices. Implementing and enforcing policies that address patient identification and procedure verification processes to prevent errors, as well as ensuring that staff are continually trained, provides radiology services with opportunities for improvements that not only can be observed by providers but can be expected by patients.
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