IAEA Regional Workshop on Justification and Appropriate Use of Imaging
From October 26-28, 2017, an IAEA Regional Workshop on Justification and Appropriate Use of Imaging was held in Zagreb, Croatia. Co-organised by the ESR and hosted by ESR 2nd Vice-President Prof. Boris Brkljačić, the workshop was attended by radiologists and officials from 18 European countries. The workshop proceedings focused on the issue of justification in radiology within the framework of the EURATOM Basic Safety Standards Directive (2013/59) which EU member states have to implement by February 2018, as well as the international basic safety standards for radiation protection and safety of radiation sources, published in 2014, which several countries have adopted nationally.
Representatives from all countries provided an overview of challenges with regard to justification in their countries, and among the most commonly identified issues was the implementation of imaging referral guidelines in clinical practice to aid referrers and practitioners in the justification process and ensure more consistent, evidence-based healthcare delivery. Representing the ESR, Prof. Brkljačić and Prof. Valentin Sinitsyn, member of the ESR Working Group on Imaging Referral Guidelines, gave lectures on ESR iGuide, the ESR's initiative to make referral guidelines available within the clinical IT workflow at the point of care. Developed in cooperation with the American College of Radiology (ACR) and National Decision Support Company (NDSC), ESR iGuide is a clinical decision support system utilising the ESR's referral guidelines based on the ACR Appropriateness Criteria. ESR iGuide has been implemented in hospitals in different European countries, and the results of pilot projects show that it helps reduce inappropriate referrals and increase adherence to guidelines.
In addition, ESR and NDSC are planning to provide a public-access ESR iGuide web portal. Portal access will be free for ESR members, and the portal can serve as a tool to support EU member states with meeting the BSS directive's requirement to make guidelines available to referrers.
Radiation protection regulations also include clinical audit requirements. Presenting the ESR's clinical audit initiative, Prof. Sinitsyn explained the ESR's concept of audit as the systematic and structured examination or review of radiological procedures against agreed standards with the aim of improving the quality and outcome of patient care. The ESR's revised Audit Tool released in 2017 provides guidance on performing effective audit against 17 patient safety standards that the ESR considers essential. The audit templates wer recently piloted within the ESR EuroSafe Imaging Stars network, a voluntary network of imaging institutions in Europe committed to best practice in radiation protection under the umbrella of the EuroSafe Imaging campaign to improve radiation protection in Europe. Twenty-one EuroSafe Imaging Stars tested the templates from June to October 2017, and the results are currently evaluated.
Education and training of the professionals involved in medical imaging was another issue of interest across different countries. Through EuroSafe imaging the ESR offers guidance, educational materials and various tools to its individual and institutional members to promote best practice and help them meet the requirements of European legislation and international guidelines on radiation protection.
A publication on the workshop proceedings will be published in the ESR's open access journal Insights into Imaging soon.