Performance indicators for radiation protection management: suggestions from the European Society of Radiology

European Society Of Radiology (Esr)

doi:10.1186/s13244-020-00923-1

Abstract

In 2013, the new European Basic Safety Standards Directive 2013/59/Euratom (BSS Directive), which defines the new legal framework for the use of ionising radiation in medical imaging and radiotherapy, was published. In 2014, the ESR EuroSafe Imaging Initiative was founded with a goal in mind “to support and strengthen medical radiation protection across Europe following a holistic, inclusive approach”. To support radiology departments in developing a programme of clinical audit, the ESR developed a Guide to Clinical Audit and an accompanying audit tool in 2017, with an expanded second edition released in 2019 and published under the name of Esperanto – ESR Guide to Clinical Audit in Radiology and the ESR Clinical Audit Tool, 2019. Audits represent specific aspects at a certain point in time, usually with retrospective evaluation of data. Key performance indicators (KPIs), on the other hand, are intended to enable continuous monitoring of relevant parameters, for example to provide warnings or a dashboard. KPIs, which can, for example, be recorded automatically and visualised in dashboards, are suitable for this purpose. This paper will discuss a selection of indicators covering different areas and include suggestions for their implementation.

Highlights

In 2013, the new European Basic Safety Standards Directive 2013/59/Euratom (BSS Directive), which defines the new legal framework for the use of ionising radiation in medical imaging and radiotherapy, was published
A total of ten objectives was defined [1]. Two of these targets address the issue of radiation protection in association with diagnostic imaging studies: These goals are: Introduction Medical radiation exposure submits the population, as a whole, to a significant radiation dose approximately equivalent to natural radiation exposure
In 2013, the new European Basic Safety Standards Directive 2013/59/Euratom (BSS Directive), which defines the legal framework for the use of diagnostic and interventional radiological procedures, was published [2, 3]

Summary

Key points

Typical questions in radiology are, for example, the range of frequency of need to repeat exposures (re-take range), whether a wrong patient has been examined, whether artefacts are recorded, or adverse effects of the administration of contrast agents or dose events are documented and analysed [9–12] Due to their structure, and the time required to complete them, regular audits are not a tool for timely monitoring of process quality. Monitoring artefacts Artefacts can significantly limit the informative value of radiological examinations, for example extracorporeal foreign bodies that overlap essential parts of the region to be examined or prostheses that impair the assessment of the lymph node stations in the pelvis The detection of such artefacts and the impact in terms of limitation of significance or repetition rate may be a relevant quality indicator. Various KPIs are proposed for such a task

During examination

Post-exposure

Conclusion

Findings

Procedure Computer tomography Over sampling