The program seems to be working well. In terms of quality assurance within the facility, we utilize a complex of professional standards and programs, JCAHO reviews, and government requirements to ascertain a proper mix for ongoing quality improvement efforts" (ACR). "The institution and department QA programs [are] based upon published guidelines and professional associations and in compliance with state and federal agencies. They were developed by adhering to in-house expertise. They seem to be working well" (ARRS).

Question 9 (N = 17)

The 1981 Consumer-Patient Radiation Health Safety Act provides minimum standards by the Federal Government for the accreditation of education programs for persons who administer radiologic procedures and for the certification of such persons. Do you adhere to these standards? Are they effective?

In response to this question we received 17 replies: 11 from professional associations, societies, and industry; 5 from states; and 1 from miscellaneous sources. Many of the respondents were not aware of act's existence. Of those who were, most seemed to think that, at best, it had a minor impact. As the American Society of Radiologic Technologists explained: The act "laid the groundwork for what could have been a step in the right direction for reducing risks and improving cost effectiveness in the use of ionizing radiation by setting minimum standards for the certification of persons who administer radiologic procedures. However, because the standards set in the Act were made voluntary, this Act became a totally insufficient piece of legislation" (ASRT). Other respondents commented on the volatile political issue regarding certification and licensure: "NRC has been subject to political pressure from various medical lobbying groups whenever it has attempted to rigidly enforce the requirement for certification of education of various professional groups. Exceptions made in the area of nuclear cardiology are but one example" (MS-KCC). Despite this issue, many acknowledge the need for such certification. "In order to assure proper standards, all health practitioners should be licensed, including nuclear medicine technologists. … In New York we have no licensing for technologists in Nuclear Medicine. New York State requires certification when a technologist is responsible for radiopharmaceutical administration. Licensure would assure attainment of an appropriate level of training" (NSUH).

Particularly illuminating were the responses from various state radiation agencies: "The State of Florida adheres to the Radiological Technologist Certification Act which we consider effective. It states that all educational programs for certified radiological technologists [must] include documentation of accreditation by the American Medical Association Committee on Allied Health and [must be] currently approved by the United States Department of Education." "Illinois requires minimum standards of education, including continuing education, for persons who perform medical radiography, nuclear medicine technology



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