WP Inspection Competence of Authorities

Transcription

1 WP Inspection Competence of Authorities Eva G. Friberg (chair) and Steve Ebdon-Jackson 1

2 Action Plan Tasks: Survey on clinical competence 2012 Clinical training courses for Inspectors in UK 2014 HERCA Inspection Workshop on radiology

3 Background Justification and optimization two of the fundamental principles of radiation protection (ICRP) To be carried out for every individual exposure (BSS) Regulatory bodies have an important role in promoting and ensuring that justification and optimization is properly implemented at medical imaging facilities 3

4 Inspector competence HERCA survey of inspector competence among MS (2012) RESULTS: Different regulatory infrastructures among MS Lack of clinical competence of many inspectors Fail to inspect justification and optimization IDENTIFIED NEEDS: Inspectors to gain sufficient competence to advice and influence the justification and optimization processes for medical exposure 4

5 PHE Inspector Training Course Following the successful pilot of the module on optimisation of diagnostic imaging in a clinical setting it was agreed that: PHE would continue to provide this training if there was sufficient demand A survey would be circulated to HERCA members to ascertain demand June 2015 The survey was intended to ascertain demand for modules focussing on optimisation in Radiotherapy and Nuclear Medicine S.Ebdon-Jackson 5

6 PHE Inspector Training Course 13 surveys were completed 54% were likely to send delegates 46% were not 85% were interested in nuclear medicine and radiotherapy modules Major reason for negative responses cost (2,600 Euros per delegate) Courses may be provided on the basis of requests and staff availability S.Ebdon-Jackson 6

7 HERCA MedInspector 2015 Hosted by FANC 6-8 th of October in Brussels Leaflet, program and registration form on HERCA web (BoH Lisbon, WGMA Helsinki) Fee: 150 Euro 7

8 HERCA MedInspector 2015 Aim: Disseminate and harmonize good inspection practice among participating countries Identify areas of improvements Focus: Diagnostic radiology, not NM or RT Topics: Justification and optimization patient & occupational Target group: Inspectors with several years experience 8

9 Program 2 ½ days, 10 sessions Presentations & WG WG templates 9

10 Social program Get together at FANC (day 1) Workshop dinner at local restaurant (day 2) Good platform for networking 10

11 Overview of participants Participants from 21 European countries Belgium (7), Czech Rep (3), Denmark, England (4), Estonia, Finland (2), France (2), Germany (2), Greece, Hungary, Ireland (2), Lithuania, Luxembourg, Netherlands, Norway (3), Rep of Macedonia, Slovenia, Spain, Sweden (2), Switzerland (2) International delegates (Outcome 18, BoH) IAEA: 4 (Albania, Rep. of Macedonia, Bosnia/Herzegovina, Croatia) WHO: Malaysia (MoH) Totally: 45 11

12 Group picture 12

13 Conclusions from workshop Regulatory framework: Real world perfect world Level of independent regulatory body, number of regulatory bodies, level of regulatory framework and legal power, available resources and competence Potential for improvements across Europe Different ways to inspect across Europe Measurements on equipment, large county reviews, thematic inspections, make use of clinical audit reports, something in between Different methods have different kind of values Useful to evaluate inspections Inspections is an effective tool for implementing justification and optimization 13

14 Conclusions from workshop Medical exposure is different from other situations Directly expose and individual by purpose No dose limits/constraints (though DRLs) Medical exposure is complex: Justification in 3 levels, optimization Important to understand the term: doing more good than harm Inspectors must have some clinical understanding/practice to fully understand the big picture of medical exposure Important when inspection medical exposure: Maintain credibility, position of authority, expert on regulations Inspector competence Multidisciplinary inspection team with clinical competence is important Inspection workshops and inspection exchange was evaluated to be positive and to be organize between countries with no language barriers 14

15 Conclusions from workshop Most countries inspect optimization, few inspect justification Possible to inspect if a system of justification and optimization is in place (QA-system) and implemented in daily use even with lack of clinical competence Not inspectors role to evaluate the appropriateness or level of optimization Need for a clear regulatory framework on justification responsibilities of health professionals and regulatory bodies Legal power to access patient-related information Clinical audit good tool to evaluate justification results & report available during inspection (not implemented in all countries yet) DRLs an efficient tool in the optimization process if the concept is fully understood and used correctly Not fully understood, not a regulatory tool 15

16 Outcome of the workshop Presentations now available on HERCA web Workshop report with conclusions and take home messages will be performed and put on the HERCA web in near future Evaluation of workshop is performed Identified HERCA action Justification core stone in RP Important to inspect Few countries inspect justification need to rise awareness Estimated 20-30% unjustified examinations need to act 16

17 European Action Week Inspection of justification in medical imaging Inspections on justification in all HERCA countries Same template, same procedure Starts on radiology day 2016 (8-15 th of November 2016) Launch the idea at ECR 2016 and summarize results at ECR 2017 (if possible) Increase the awareness of justification (European & National awareness campaign) Time is right Transposition of EU-BSS Drafting of EC conclusions (incl. justification) Radiology day 2015 (8 th of November) ISRRT focusing on RP 4-8 th of March 2016: ECR with focus session on RP 10 th of March 2016: HERCA multi-stakeholder meeting on justification March 2016: IAEA TM on justification? To be cooperated with the WP Justification 17

18 Evaluation of the workshop Quest-back evaluation form Information of workshop and registration process Venue and local organization Workshop content and performance Outcome and future workshops Response rate: 89% Rate statement from 1 to 5: 1 = totally disagree, 5 = totally agree 18

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22 Evaluation of inspector workshop 92% attended the social program (get-together and dinner) and 92% found this important for networking 100% support further arrangements of inspection workshops, all found it to be a good platform for networking and 87% would have attended again if topic is of interest Areas to be covered: NM (71%), RT (69%), Radiology (63%), special topics of interests were collected 30% had difficulties to get support/founding by local authority Most countries identified good practices to take home 84% supported the idea of an European Action Week 22

23 Acknowledgement Local organizing committee at FANC Katrien Van Slambrouck Jolien Berlamont Marie-Claire Meerkens Jean-Pierre Hallot Core group Steve Ebdon-Jackson (UK) Torsten Cederlund (Sweden) Richard Elek (Hungary) Maria Kalathaki (Greece) THANK YOU ALL!!! 23

24 Summary All tasks completed Workshop was a success with good feedback Great interests for future workshops (100%) Identified HERCA initiative European Action Week (84%) Proposal for approval by BoH Continuing WP on Inspector Competence change focus Identified tasks: European Action Week (November 2016) Future Inspection Workshops (late 2017 on RT) If approved, prepare for the next BoH meeting A new action plan Layout of European Action Week 24

25 Thank you for your attention! 25