RADIATION SAFETY CULTURE IN MEDICINE

Radiation Safety Culture in Medicine

Medical physicists have responsibility for patient protection as described in International Basic Safety Standards (BSS). Additionally, medical physicists may share responsibility for occupational protection, as described in BSS. A series of over exposures in last few years have brought the need for safety culture in use of ionizing radiation in medicine.

While medical physicists in large part of the world are involved in day-to-day strengthening of safety culture, IOMP’s role has been in:

  1. Revision of BSS and with its content on Radiation Safety Culture
  2. Review of Safety Guide of IAEA and as in training course on implementation of safety guide
  3. Organizing sessions in World Congress (WC) on Medical Physics & Bio-Medical Engineering, June 2015 at Toronto on Implementation of BSS and Safety Culture in Medicine, in similar WC in Prague in June 2018 and in International Conference on Medical Physics (ICMP) held in Santiago, Chile in Sept 2019, under the lead of Madan Rehani. All these events were in cooperation with IRPA and WHO.
  4. Publishing article in IOMP publication- the Electronic Medical Physics World (eMPW)
  5. Survey on impact of regulations on radiation safety and development of radiation safety culture in 25 countries, published in a journal
1st Regional Workshop on Radiation Protection Culture in Medicine held in Buenos Aires on 11th April 2015 for Latin. Prof. American countries. IOMP was represented by Dr Simone Kudlulovic Renha represented IOMP.

A new IRPA, WHO, IOMP Initiative on Radiation Protection Culture in Medicine

B. Le Guen1, M. Perez2, S. Simone Kodlulovich3, and A. Bomben4
1IRPA, 2WHO, 3IOMP-ALFIM, 4SAR

As a follow-up of the publication of the Guiding Principles for Establishing a Radiation Protection Culture, IRPA wanted to explore the possibility of developing practical guidance for the medical sector. A new initiative was launched by IRPA in cooperation with IOMP, WHO and all RP professionals, for capturing the opinion of stakeholders to develop a document providing guidance for the establishment and maintenance of a radiation safety culture in health care settings.

The first step of this new project was the organization of a Regional Workshop on Radiation Protection (RP) Culture in Medicine in Buenos Aires, Argentina, on 11th April 2015. This workshop, which was a satellite event before the 10th Latin American IRPA Congress, gathered 68 participants representing regulatory bodies, health authorities, health professionals (radiologists, radiographers, medical physicists, nuclear medicine physicians, radiation oncologists, interventional cardiologists, dentists, paediatricians), manufacturers, and patients associations. The working languages were Spanish and English, with simultaneous interpretation.

The first part of the workshop consisted in plenary sessions for setting the scene, presenting the existing initiatives relevant for RP culture in medicine and listening to the voice of key stakeholders in the field of medical uses of radiation. Three break out groups then identified the key elements to be considered in the process of establishing and maintaining radiation protection culture in health care settings, and propose a preliminary framework that will provide a basis for the future development of the guidance document. The following topics were addressed by the break out groups:

1. Key elements for the establishment of RP culture in medicine.
2. Priorities in Latin America for building a solid RP culture in health care settings
3. Mapping relevant stakeholders in RP culture in medicine

Some of the identified key elements for establishing an RP culture in medicine were the following: commitment /motivation, engagement of leaders and managers, cooperation between stakeholders, establishment of standard levels of education, training and continuous professional development, effective communication, harmonization of terminology/common language, awareness of risks/risk perception, implementation of corrective action programmes linked to a blame-free policy, quality system implementation, use of incident reporting and learning systems, prospective risk analysis/use of risk matrixes, transparency/ information sharing, information), leadership associated with interdisciplinary teamwork, integration of radiation protection into patient safety procedures/systems, accreditation and recertification programs for health professionals, allocation of financial resources for RP culture, creation of “ad hoc” RP culture committees.

The barriers, solutions and priorities in Latin America were discussed, taking account of the current situation i.e. great variation in the levels of RP inter-county, inter-state/province, inter-institution, lack of legislation in some countries, lack of referring physician awareness. As a short term action was proposed a commitment to start working towards the establishment of a RP culture in medical facilities in Latin America. The following pledge was proposed: “In our hospital we work as a team to ensure effective use of radiation and protect the patient and our staff”.

There is a need to identify concrete and specific actions to establish a RP culture in medical facilities, taking into account the huge differences between them. It could be considered the creation of a regional work group/task force with defined, responsibilities to guide and coordinate this work in the countries, in collaboration with the international organizations (i.e. a “globally/regional supported, locally implemented” approach). The first product would be a work plan (short, medium and long term), with defined priorities, goals and strategies.

This workshop was the first of a series of similar events aimed to collect feedback for the development of the future guidance document. The current plan is to hold regional workshops open to all countries in at least 4 regions of the world. Registration to these workshops is free of charge. The next workshop will take place in Europe, hosted by WHO in its headquarters in Geneva (30th November- 2nd December).

A Focus on Paediatric Radiology

Establishing a Sustainable Safety Culture Program in Medicine In cooperation with the South African Society of Paediatric Imaging Spier Estate, Stellenbosch, South Africa, 3 November 2016

The 3rd Regional Workshop on RSCHC was structured around a number of invited plenary presentations, followed by facilitated breakout sessions in small groups. Each group will examine topical issues in greater details, particularly focusing on the following topics:

  • Key elements of a radiation safety culture in paediatric imaging
  • A strong radiation safety culture in paediatric radiology
  • How to engage parents in RSCM improvement?
  • Improving RSCM in Africa: SWOT analysis
  • Tools and indicators for assessing RP culture in QA program in medicine

WYNDHAM GRAND REGENCY DOHA, AL SADD AREA, DOHA, QATAR
6-7 FEBRUARY 2017

The 4th Regional Workshop on RSCHC for Middle East countries is jointly organized by the International Radiation Protection Association (IRPA), the International Organization for Medical Physics (IOMP), and the World Health Organization (WHO), in cooperation with the Middle East Federation of Organizations of Medical Physics (MEFOMP), and the Hamad Medical Corporation.

In order to stimulate reflection it will be structured around a number of invited plenary presentations combined with facilitated breakout sessions in small groups. After the presentation of the results to the plenary, a general discussion will be held to get a common understanding about key elements and principles for establishing and maintaining a radiation safety culture in health care, and how they can be better reflected in a framework document.

The joint Workshop was one among the 4 events that were held in the week of 6-10 Nov 2017. These were:

  1. Joint workshop of International Organization for Medical Physics (IOMP)- International Radiation Protection Association (IRPA)- World Health Organization (WHO) and IAEA on 8-10 Nov.
  2. Celebration of International Day of Medical Physics (IDMP) on 7th November
  3. Celebration of International Day of Radiology (IDOR) on 8th November.
  4. IAEA Regional Workshop on Dose Optimization-Analysis and Interpretation of Patient Dose Data on 6-10 Nov.

The events were held at the National Cancer Center, Putrajaya. The Director General of Health, Malaysia Datuk Dr Noor Hisham Abdullah came on 8th and the celebrations were to open all events even if some had started and were ongoing.

IOMP had full visibility as is evident from links below and pictures:
https://putrajayawhoiaea.weebly.com/

The press statement of DG Health contains mention of IOMP:
https://kpkesihatan.com/2017/11/08/press-statement-dg-of-health-8th-nove…

There were a total of 110 participants on 8-10 Nov even though the opening function on 8th had nearly 250 persons.
In addition, there were banners and direction signs from the entrance of the building to Auditorium and meeting
room, all having IOMP name and logo including the conference bag.

IDMP celebration was done from University of Malaya in Kula Lumpur and was broadcasted live. The YouTube link for IDMP celebration is as below:
https://www.youtube.com/watch?v=K1bG8VCc_qk

The joint Workshop, which is 6th in series of similar workshops was held at Hotel Sheraton San Diego and Marina on 20-21 Feb 2019. It was held in conjunction with midyear meeting of the Health Physics Society.

Dr. Rehani was invited to give keynote lecture on “Radiation Safety Culture:  What, why, when and how?”

There were around 50 participants mostly radiation safety officers. In keeping with previous workshops, a representative of patient through Patient for Patient Safety program of WHO was invited. Maria Perez represented WHO, Bernard Le Guan (IRPA) and Debbie Gilley (IAEA). The host coordinator was Steve King from Penn State University. Dr. Rehani also was a panelist in the panel discussion on deliberation of joint document of cooperating organizations that is under preparation and will be published by WHO. Dr. Rehani also made a presentation on IOMP’s role in the session on Stakeholders point of view session and chaired a breakout group. This event filled the gap for the North America as previous events were held in other parts of the world as: Latin America (Buenos Aires), Geneva (Europe), Stellenbosch (South Africa), Qatar (Middle East), Putrajaya (Asia).