Enhancing radiation safety culture in health care: guidance for health care providers (10 July 2024)

Summary

Radiation safety culture in health care encompasses every action taken to improve the protection and safety of patients and personnel involved in medical exposure. This report provides a framework to establish, maintain and enhance radiation safety culture in health care. It highlights patterns of organisational and individual thinking and behaviours which define a positive safety culture and provides a set of tools to assess the existing level and quality of radiation safety culture and good practice examples.

The publication was developed by the World Health Organization (WHO) jointly with the International Atomic Energy Agency (IAEA), the International Organization for Medical Physics (IOMP) and the International Radiation Protection Association (IRPA).

Content

The key messages of the publication are the following:

• Actions taken to enhance the protection and safety of patients and personnel involved in medical use of radiation represent radiation safety. These actions lead to radiation safety culture when organisational and individual characteristics and attitudes that determine how everyone practices radiation safety are considered and embedded within an organization (e.g., ideas, values, behaviours and customs).
• Anyone with a safety concern or perceived safety concern should be empowered to raise awareness and resolve the issue before commencing activities.
• Leadership, management and personal accountability are critical factors in enhancing radiation safety culture, and those involved in radiation safety should prioritize them as such.
• Understanding the errors affecting patient safety has developed from a simple causal model to one that considers a complex mix of behaviours and interactions influencing the environment and outcome.
• Implementing the principles of justification and optimization is essential to ensure that radiation used in health care is managed safely.
• Engagement strategies must be tailored to the diverse groups of stakeholders contributing to radiation safety culture.
• Everyone in the diverse groups of stakeholders is responsible for assuring a strong radiation safety culture in health care aiming that patients are imaged and treated correctly.
• Communication, education and training are considered essential for establishing and maintaining radiation safety culture.
• There needs to be consistent and coordinated understanding of radiation safety culture among the many stakeholders within health care, which acknowledges the varying perceptions.
• Everyone can participate in strengthening safety culture. There are international, national and local initiatives to help health care providers improve radiation safety.
• A combination of optimal tools is required to establish and maintain radiation safety culture. This includes standards and regulations, policies and procedures, education and training, audit activities, communication strategies, reporting and learning systems, checklists, verification procedures, time-out procedures as well as technical developments.
• A positive safety culture can be defined by ten traits: leadership responsibility, individual responsibility, continuous learning, effective safety communication, respectful work environment, problem identification and resolution, environment for raising concerns, decision-making, questioning attitude and work processes.
• Good practices to improve safety culture shared by radiation health care providers can be adopted/adapted around the world.
• Existing frameworks proposing assessment tools and performance indicators can be adopted and adapted to the local context to assess level and quality of radiation safety culture.

Related reading

• Raising awareness and protecting staff from ionising radiation: an interview with Katie Hurst