By Beth Allen, CRA, RT(R)(CT)
In November 2025, I came across a post on the AHRA forum that would become a meaningful conversation for several members across the country. The topic was establishing a policy for imaging performed on the incorrect body part or patient. This clearly resonated across the field, reflecting just how widely this challenge is felt throughout the imaging community. Recognizing the opportunity, Jacqui Rose, MBA, CRA, RT(R), FAHRA, took the initiative to collect our names and set up a group discussion. Jacqui serves as the system director of radiology at University of Cincinnati Health. She is also a past president of the AHRA and understands the power of that community.
We all met in a Teams meeting in December. What began as an informal conversation has grown into a monthly working session with a clear purpose: to make imaging safer for our patients and our team members.
Why Imaging Errors Are on the Rise
We all agreed that imaging errors have increased. While there doesn’t seem to be one single factor responsible, we have identified several root causes. We don’t have a piece of paper to refer to anymore; our technology has not kept up with safety protocols to ensure all the information agrees; our team members and our patients are more distracted than ever. We are being asked to do more with less and work faster than ever. Referring providers also have obstacles to contend with, so the orders we are receiving may include errors. We are expected to catch those as well.
Imaging safety extends well beyond performing an incorrect examination. The scope of potential harm is serious. This team, an AHRA national safety collaboration, is committed to an all-inclusive approach to errors that occur in the imaging suite, including MRI safety events, incorrect interventional procedures and misadministration of medications and radiopharmaceuticals.
Supporting the Second Victim
When an imaging error occurs, the most visible harm is to the patient. But these errors also impact our team members. It has been well established in safety science that the people involved in performing the error are second victims. These are dedicated, hardworking and well-intentioned people working to get it right for every patient, every time. When an error is made, it can cause anxiety, remorse and fear. At the end of the day, we are all human and capable of human error. We need solid routines and processes to adjust for that.
The AHRA team is guided by safety science, process improvement principles and Just Culture. We recognize that sustainable improvement requires accountability along with a psychologically safe environment so team members will self-report without fear of punitive consequences.
The goal of our group is to find solutions that will work across our industry to decrease the likelihood of errors and share best practices. We want to engage vendors that manufacture and support our equipment to ensure safety considerations are embedded into the design of new features, software platforms and imaging systems. Hopefully, we will find ways to identify and close the gaps in our processes by learning from past errors, near misses and adverse events, so we don’t make them again.
Building a National Benchmark for Imaging Safety
To begin building a benchmark, which does not currently exist, the AHRA Imaging Safety Improvement Team has launched a national survey. The survey is designed to capture data on the frequency, type and context of imaging errors across many institutions. The goal is to establish a reliable, evidence-based baseline against which future progress can be measured.
In addition to this benchmark, we are building a complete process improvement project library, best practices and Just Culture models for leaders to reference to improve overall safety of their departments quickly and easily.
This initiative has gotten the attention of the ACR, which has shown interest in the benchmark and the work the national collaboration is doing. Clearly, this conversation that started on the AHRA forum is now resonating at the highest levels of our imaging profession.
This is only the beginning. As this team continues to learn and grow, additional recommendations and opportunities will be shared with our broader imaging community. The goal is not to document an issue; it is to drive lasting change. Imaging safety is a shared responsibility that extends across each patient’s healthcare journey. It is one that honors not only the patients we serve, but also the imaging team that serves them.
Thanks for all you do. •
Beth Allen, CRA, RT(R)(CT), is the director of clinical operations with Banner Imaging.
