Safety reporting, analysis and learning in optimisation of radiological protection for medical imaging

Radiological medical imaging services aim to provide a high standard of anatomical imaging to aid diagnosis and treatment of patients' diseases. The services depend on use of the latest techniques to perform the procedures requested reliably with the minimum amount of radiation. Developing and improving such systems requires attention to prevention of any errors in the process and potential refinements in optimising radiological protection. Prevention of incidents requires any unnecessary exposure that does occur to be investigated, events analysed to identify points of potential failure and action taken to address any deficiencies. Optimisation of radiological protection and reduction of imaging dose require understanding and awareness of the techniques and how they might be adapted for individual patients. Both require staff educated and trained in imaging techniques who build on their experience and develop the services with time. Systems for prevention of incidents and optimisation of radiological protection are not just based on assessment, protocol design and analysis when imaging equipment is installed but involve continual review so that improvement becomes part of an established culture within the organisation. Issues requiring particular attention have been highlighted by the International Atomic Energy Agency and the International Commission on Radiological Protection has further expanded the discussion on some of these issues in recent publications. These deal with ethics in radiological protection for patients in treatment and diagnosis and optimisation of radiological protection in imaging. This paper draws these aspects together to emphasise common elements in the requirements and approaches as well as the need for the continual refinement to become part of the radiation safety culture within the organisation.