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Enhancing Patient Care: European Experts Meet on the Margins of GC64 to Strengthen Safety and Quality in Radiation Medicine

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The side-event was opened by Alexey Katukhov, IAEA Programme Management Officer, and by Eve-Kulli Kala, Director of the TC Division for Europe. (Photo: O. Yusuf/IAEA)

Medical uses of ionizing radiation are amongst the longest-established applications of ionizing radiation, and at the same time one of the most rapidly developing areas. The medical benefits of the use of ionizing radiation are indisputable, but there is an associated radiation risk for patients and medical staff. Therefore, a systematic approach must be taken to ensure that a balance is in place between the medical benefits of ionizing radiation and its risks.

To help address the challenges of implementing systematic quality and safety measures, and to support the identification and exchange of best practices in the field, more than 140 experts and delegates from the Europe region attended a 29 September side-event, held on the margins of the Agency’s 64th General Conference.

“Through its TC programme, the IAEA provides assistance to countries to secure access to medical radiation technologies, and to subsequently build capacities for their safe use,” said Eve-Kulli Kala, Director of the IAEA’s Technical Cooperation (TC) Division for Europe. “This approach allows countries to extract the maximum benefit from radiation technologies, while simultaneously considering, calculating and minimizing risk.”

Radiation safety is a cornerstone of high-quality healthcare. Any clinical department using ionizing radiation should implement a system to maintain standards for quality and safety which includes a quality assurance and radiation protection programmes for medical exposure, with clearly-defined roles and responsibilities. The system should be embedded into healthcare processes and should be supported by both a national authority for radiation protection and by national legislation.

These principles were central to the discussions and deliberations which emerged throughout the side-event, held on 29 September, just 12 days after the annual observation of World Patient Safety Day, 17 September.

The virtual side-event benefitted from the attendance of more than 140 counterparts, experts and stakeholders in the region. (Photo: O. Yusuf/IAEA)

Identifying and Addressing Gaps

General Safety Requirement Part 3 provides a solid basis for the Member States to develop their national legislation for radiation protection in medicine. However, its successful implementation related to medical exposure — including the exposure of patients, carers, comforters and volunteers in biomedical research — is a significant challenge,” said Dean Zontar, an Inspector-Councillor at the Slovenian Radiation Protection administration.

Zontar also delivered a presentation on behalf of a group of experts who evaluated current adherence to the IAEA’s Safety Standards for radiation protection in medical exposure. Using the IAEA Radiation Safety Information Management System (RASIMS) and other relevant information, he demonstrated how and where progress had been achieved by Member States in Europe and Central Asia receiving TC support, and underscored the challenges which persist.

“Although the Europe region is seen as having good radiation protection and safety regulatory systems, there are still many gaps in both regulatory requirements and in their implementation in practice,” Zontar said. “In many countries there is an apparent lack of understanding of the specifics of regulating medical exposure, and further support to improve understanding is needed,” he added.

To provide this kind of support, the IAEA routinely develops, disseminates and delivers training and expert guidance to countries around the world to support the work of the regulatory bodies, medical radiation facilities  and healthcare staff involved in the diagnostic and therapeutic use of ionizing radiation.

“Cooperation between stakeholders such as regulatory authorities, health authorities and medical professional bodies is essential and should be improved,” said Jenia Vassileva, an IAEA Radiation Protection Specialist who addressed the side-event participants, explaining the Agency’s role in strengthening patient protection regimes. “The TC Europe region will be the first to benefit from comprehensive advisory missions to Member States to support their full adherence to the IAEA safety standards for medical exposure.”

Quality assurance is an important component of IAEA support in the field of medical imaging. Virginia Tsapaki, an IAEA Medical Physicist specializing in diagnostic radiology, underscored this association between quality and imaging in her subsequent presentation.

 “Quality assurance and dosimetry is critical in medical imaging. A mistake, misuse or malfunction of an X-ray machine can affect the diagnosis of the patient,” explained Tsapaki. “X-ray systems must be closely monitored using established quality assurance programmes and the use of machines should be tailored to each individual patient’s needs.”

Jenia Vassileva, an IAEA Radiation Protection Specialist, explained how, by whom and according to what principles patient protection regimes are developed and deployed. (Photo: O. Yusuf/IAEA)

Staffing Requirements

Adnan Beganovic, a medical physicist from Bosnia and Herzegovina, presented the findings of a recent survey regarding the availability of medical physicists in the region. The work of medical physicists is central to optimizing medical procedures involving radiation.

“A survey instrument based on a staffing algorithm, previously created by the IAEA, was used to investigate the medical physics workforce. The study identified deficiencies in many countries. Regulatory framework, which imposes mandatory quality control by third-party institutions, causes a reluctance among hospital management to recruit medical physicists,” said Beganovic.

The discussion which followed sought to  identify remedies and activities that would help to ensure that the appropriate capacities are available when considering the deployment of radiation in a medical context.

Background

The International Basic Safety Standards (BSS) and the IAEA’s General Safety Requirements 3 establish a series of conditions and obligations for governments to set an adequate national framework to ensure that the use of radiation in medicine is safe.

Medical facilities which deploy radiation are required to maintain a system of measures to ensure that every exposure is well justified and delivered with the minimum dose needed to achieve the diagnostic or therapeutic outcome for the patient. Optimization of radiation protection has several important components and requires the involvement of different groups of health professionals. One important part is quality control, which consists of structured procedures and actions aimed at maintaining a high level of safe operation in order to avoid accidents.

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