The Radiology Events Register (RaER)
Project leaders: Dr Neil Jones and Dr Catherine Mandel
The Radiology Events Register (RaER) is an initiative sponsored by the Quality Use of Diagnostic Imaging (QUDI) Program and managed by the Australian Patient Safety Foundation (APSF) with support from Patient Safety International (PSI).
The aim of RaER is to develop a means of systematic data collection and analysis of incidents in radiology, in order to obtain reliable data to assist quality improvement and increase patient safety.
RaER is a professional database for the reporting of radiology incidents. An incident is an event or circumstance which could have resulted, or did result, in unintended or unnecessary harm to a person and/or a complaint, loss or damage.
The tool for data collection and analysis is the Advanced Incident Management System (AIMS), which was developed by the APSF, and is used by many hospitals in Australia and overseas. This system has been tailored for the particular needs of radiology incidents.
Importantly, the database encourages the reporting of “near-misses” or “close calls”. This is because we can learn from these incidents even when there is no harm caused. They also occur more frequently than the adverse events for which they are precursors, providing a rich source of data to analyse and learn from.
To report an incident, go the the RaER website and click on "report an incident". You will be given the choice of reporting anonymously or with a username and password provided by APSF.
The data in RaER is subject to protection through the Commonwealth Qualified Privilege Scheme. Radiologists may have considered reporting an incident that they felt had important messages and learnings that the system and their colleagues could benefit from, but wondered about the level of individual or organizational legal protection that would accompany such a quality and safety improvement process. A document titled Qualified Privilege and RaER [60 kb] addresses the key points in a clear fashion.
The RaER progress report - second phase provides an update on the development of the RaER database, the achievements so far and obstacles encountered during the period 2007-08. This report and other related documents are available on the QUDI Projects Archive page.
RaER case reports
The RaER case reports are the result of the classification and analysis of incidents in the RaER database. They provide us with examples of how we can learn from an incident or a type of incident and apply it to quality improvement in radiology practice.
- RaER Report Aug 08 - 3Cs medical imaging incident [190 kb]
- RaER Report Sep 08 - Extravasation of iodinated contrast medium [178 kb]
- RaER Report Oct 08 - Communication error at the core [168 kb]
- RaER Report Nov 08 - Swiss cheese and time out [358 kb]
- RaER Report Nov 08 - Handover of acute care patient [168 kb]
- RaER Report Dec 08 - The anonymous referral [163 kb]
- RaER Report Dec 08 - MRI medley [176 kb]
- RaER Report Jan 09 - Health information technology [203 kb]
- RaER Report Jan 09 - What happens when your patient is unable to communicate [205 kb]
- RaER Report Feb 09 - Health associated infections and medical imaging [186 kb]
- RaER Report Mar 09 - Detective work in the CT Room [195 kb]
- RaER Report Mar 09 - To err is human; to forgive divine [177 kb]
- RaER Report Apr 09 - Feeling left right out [180 kb]
- RaER Report Apr 09 - Work Load - When it all gets too much [176 kb]
- RaER Report Jun 09 - Lost in eSpace [186 kb]
- RaER Report Jun 09 - A surgical disaster: Could this happen in radiology? [315 kb]

