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With the redefinition of the sentinel event, my interpretation is that increases the obligation for monitoring for skin effects even if you are not compelled to track and document high dose fluoro cases. This is only reasonably manageable if</div>
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<meta http-equiv="content-type" content="text/html; charset=utf-8"></head><body dir="auto">With the redefinition of the sentinel event, my interpretation is that increases the obligation for monitoring for skin effects even if you are not compelled to track and document high dose fluoro cases. This is only reasonably manageable if you conservatively prioritize follow-up on patients whose CAK is in the range where deterministic effects might occur if all fields overlapped and the patient was at the IRP. However, since the fields rarely completely overlap except for EP cases, you might set the threshold at 5 Gy for non EP cases and require post procedure skin monitoring, which is exactly what many sites without a dose monitoring software solution were doing to comply with the JC’s prior requirements. <div><div><br></div><div><br id="lineBreakAtBeginningOfSignature"><div dir="ltr">Sent from my iPhone</div><div dir="ltr"><br><blockquote type="cite">On Aug 24, 2026, at 12:01 PM, Lemieux, Bryan P. via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list@lists.osu.edu> wrote:<br><br></blockquote></div><blockquote type="cite"><div dir="ltr"><!-- BaNnErBlUrFlE-BoDy-start -->
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Your state may still have a requirement for dose documentation, possibly in terms of at least fluoro time. Also, while JC removed some things, they still have a Sentinel Event for patient burns (which includes radiation burns). I would be very</div>
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<p class="MsoNormal"><span style="font-size:12.0pt">Your state may still have a requirement for dose documentation, possibly in terms of at least fluoro time.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt">Also, while JC removed some things, they still have a Sentinel Event for patient burns (which includes radiation burns). I would be very interested if anyone has a way to effectively and proactively identify,
investigate and intervene in possible patient radiation burns that is not tied to dose monitoring………
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt">Its also tied to some quality measures.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt"><o:p> </o:p></span></p>
<div>
<div>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Bryan Lemieux MS CHP DABMP</span><span style="font-size:12.0pt;color:black"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Associate Chief for Radiation Safety</span><span style="font-size:12.0pt;color:black"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Radiation Safety Officer</span><span style="font-size:12.0pt;color:black"><o:p></o:p></span></p>
</div>
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<p class="MsoNormal"><span style="font-size:12.0pt;color:black">UK HealthCare</span><span style="font-size:12.0pt"><o:p></o:p></span></p>
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<div style="border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"> Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+bryan.lemieux=uky.edu@lists.osu.edu>
<b>On Behalf Of </b>Johnson, Loretta M via Intl_dxmedphys_wd_osu_list<br>
<b>Sent:</b> Monday, August 24, 2026 9:52 AM<br>
<b>To:</b> Stephanie M. Leon <Stephanie.M.Leon@hitchcock.org>; intl_dxmedphys_wd_osu_list@lists.osu.edu<br>
<b>Subject:</b> Re: [Intl_DxMedPhys] EXT MSG Re: Requirement for dose monitoring<o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#9C6500;border:solid #9C6500 1.0pt;padding:2.0pt;background:#FFEB9C">CAUTION:</span></b><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:black;border:solid #9C6500 1.0pt;padding:2.0pt;background:#FFEB9C">
External Sender</span></b><span style="font-size:12.0pt"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
<div>
<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Is your radiation safety officer going to allow them to opt out of dose monitoring? Peace, Loretta Loretta Johnson, Ph.</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white">D.</span><span style="font-size:1.0pt;font-family:"Arial",sans-serif;color:white"> </span><span style="font-size:1.0pt;color:white">,
DABR, FAAPM | Associate Professor Division of Imaging Physics Department of Radiology | Heersink School of Medicine UAB<o:p></o:p></span></p>
</div>
<p class="MsoNormal"><span style="font-size:11.0pt">Is your radiation safety officer going to allow them to opt out of dose monitoring?</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt;color:black">Peace,</span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt;color:black">Loretta</span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:12.0pt;color:#1E6B52"> </span></b><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:12.0pt;color:#1A5632">Loretta Johnson, Ph.D., DABR, FAAPM | Associate Professor</span></b><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt">Division of Imaging Physics
</span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt">Department of Radiology | Heersink School of Medicine</span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt">UAB | The University of Alabama at Birmingham</span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt">GSB Suite #301 | 619 19<sup>th</sup> Street South | Birmingham, AL 35249</span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt">P: 205.934.7592 |<span style="color:#1A5632">
<a href="mailto:lorettajohnson@uabmc.edu"><span style="color:#1A5632">lorettajohnson@uabmc.edu</span></a></span></span><o:p></o:p></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:12.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:#1A5632"><a href="https://urldefense.com/v3/__https://www.uab.edu/medicine/radiology/__;!!KGKeukY!3PpNQTSRa_7oyKwYbJ4SBQyUn3EybE5XnTsIdRV49Iqbm_WqxuWioHJ6jRdJeAOI4wTBfHQTTMlZbsDXD_cXyVOiMeugkrF_s5vS8hYQlGKFQlVrvQ$"><span style="color:#1A5632">https://www.uab.edu/medicine/radiology/</span></a></span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
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<p class="MsoNormal"><b><span style="font-family:"Calibri",sans-serif;color:black">From:
</span></b><span style="font-family:"Calibri",sans-serif;color:black">Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list-bounces+lorettajohnson=uabmc.edu@lists.osu.edu">intl_dxmedphys_wd_osu_list-bounces+lorettajohnson=uabmc.edu@lists.osu.edu</a>>
on behalf of Dxmedphys new list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Reply-To: </b>"Stephanie M. Leon" <<a href="mailto:Stephanie.M.Leon@hitchcock.org">Stephanie.M.Leon@hitchcock.org</a>><br>
<b>Date: </b>Tuesday, August 11, 2026 at 2:21 PM<br>
<b>To: </b>Dxmedphys new list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Subject: </b>EXT MSG Re: [Intl_DxMedPhys] Requirement for dose monitoring</span><o:p></o:p></p>
</div>
<p class="MsoNormal"> <o:p></o:p></p>
<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Thanks to all who responded already! I was not imagining that there used to be a relevant TJC requirement. However, it is gone now. Stephanie M. Leon, PhD, DABR,
DABSNM Chief of Diagnostic Medical Physics Associate Professor of Radiology Tel</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt">Thanks to all who responded already! I was not imagining that there used to be a relevant TJC requirement. However, it is gone now.</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal"><b><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#639044;mso-ligatures:standardcontextual">Stephanie M. Leon, PhD, DABR, DABSNM</span></b><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#00664F;mso-ligatures:standardcontextual">Chief of Diagnostic Medical Physics</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#00664F;mso-ligatures:standardcontextual">Associate Professor of Radiology<br>
<br>
<br>
<br>
</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#00664F;mso-ligatures:standardcontextual">Tel (603) 650-3796<br>
<a href="https://urldefense.com/v3/__http:/Dartmouth-Health.org__;!!NoSwA-eRAg!ADcCl68OJkbTYrpBcJWbdN0QvZLTKoxmyLXo7HFBGr6jJOOC8jno2gtBrDZVcr590IbKEZJ--nwqMSQ1Tk4F4Qsbsk-RFLnqnNlX6Q$">Dartmouth-Health.org</a></span><o:p></o:p></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt"> </span><o:p></o:p></p>
<div style="border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"> Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu">intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu</a>>
<b>On Behalf Of </b>Stephanie M. Leon via Intl_dxmedphys_wd_osu_list<br>
<b>Sent:</b> Tuesday, August 11, 2026 2:42 PM<br>
<b>To:</b> <a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a><br>
<b>Subject:</b> [Intl_DxMedPhys] Requirement for dose monitoring **EXTERNAL**</span><o:p></o:p></p>
</div>
<p class="MsoNormal"> <o:p></o:p></p>
<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Hi all, I am trying to find in the current TJC standards any requirement for patient radiation dose monitoring for fluoroscopy. Am I missing it? Or is there a relevant
non-TJC requirement? Our cath lab wants to opt out of our dose monitoring</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Hi all, I am trying to find in the current TJC standards any requirement for patient radiation dose monitoring for fluoroscopy. Am I missing it? Or is there a relevant
non-TJC requirement? Our cath lab wants to opt out of our dose monitoring</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual">Hi all,</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual">I am trying to find in the current TJC standards any requirement for patient radiation dose monitoring for fluoroscopy. Am I missing it? Or is there a relevant non-TJC requirement?
Our cath lab wants to opt out of our dose monitoring program, and I am looking for any accreditation-related reason why they can’t (our state regs do not require it).</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><b><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#639044;mso-ligatures:standardcontextual">Stephanie M. Leon, PhD, DABR, DABSNM</span></b><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#00664F;mso-ligatures:standardcontextual">Chief of Diagnostic Medical Physics</span><o:p></o:p></p>
<p class="MsoNormal" style="margin-bottom:12.0pt"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#00664F;mso-ligatures:standardcontextual">Associate Professor of Radiology</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#00664F;mso-ligatures:standardcontextual">Tel (603) 650-3796<br>
<a href="https://urldefense.com/v3/__http:/Dartmouth-Health.org__;!!NoSwA-eRAg!ADcCl68OJkbTYrpBcJWbdN0QvZLTKoxmyLXo7HFBGr6jJOOC8jno2gtBrDZVcr590IbKEZJ--nwqMSQ1Tk4F4Qsbsk-RFLnqnNlX6Q$">Dartmouth-Health.org</a></span><o:p></o:p></p>
<p class="MsoNormal" style="margin-top:12.0pt"><a href="https://urldefense.com/v3/__https:/www.dartmouth-health.org/__;!!KGKeukY!2GlIfYKlZJ2X0OKjopqQiJqso8FX6T7mUX06M3bQPzq787W5aN9Ga1fC-jfEx9RNDnKAnv-1RHGuihSE0S2Bjd4Yso30I9_YxRvXZG_GV2zaQuOIxZxZuw$"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#7F7F7F;text-decoration:none"><div><image001.png></div></span></a><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt;mso-ligatures:standardcontextual"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:12.0pt"><br>
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