The Ukrainian Association of Medical Physicists took part in the 7th National Congress with international participation “Radiology in Ukraine”, which took place on March 27-29, 2019.
In particular, the President of UAMP Ruslan Zelinskyi made a report on “How to ensure quality and safety in diagnostic radiology: the view of a medical physicist.”
The main theses of the speech:
- The modern quality assurance system in diagnostic radiology needs to be changed, because it has a number of disadvantages:
– there are no clear requirements for quality control procedures for diagnostic equipment, each organization develops its own methods, and it is not known how to assess the quality of such methods.
– there are no clear requirements for the qualifications of personnel who can perform quality control procedures.
– there is no personal responsibility of the specialist who performs quality control procedures.
– no independent inspections (audits)
– verification of quality control protocols by the regulatory body (or protocols for verification of dose-forming parameters, as this process is called in Ukraine) is often reduced to checking the availability of this protocol without analyzing the protocol form and information entered in the protocol.
- As a result of the above shortcomings we have a number of problems:
– there are situations when the check of dose-forming parameters is not performed, but only a fictitious protocol is issued.
– heads of organizations that control dosage-forming parameters, encourage their subordinates to sign fictitious protocols, even if the inspection revealed certain deficiencies.
– control of dose-forming parameters takes place with the help of measuring equipment that is not suitable for measurements on a specific device and with the use of protocols that cannot be used for this equipment (for example, computer tomograph control is performed according to X-ray equipment control protocol)
– during inspections by the regulatory body, quality control protocols that have obvious shortcomings (not the appropriate protocol, not the appropriate equipment) are not detected and no one is responsible, neither the medical institution nor the organization that conducted such measurements.
- To address the above and other problems, it is necessary to make comprehensive changes in the formation of state policy towards ensuring the quality of radiological diagnostic equipment:
a) Abolish the concept of “control of dose-forming parameters” and use the concept of “quality control”, which is more comprehensive and is used in all international documents, recommendations.
b) Create preconditions for licensing of medical physicists, conduct licensing and legally allow only licensed medical physicists to control the quality of equipment, as the implementation of this procedure is one of the direct functional responsibilities of medical physicists.
c) It is also important to remember that the quality control procedure is not maintenance! and does not require additional licensing by the regulatory body.
d) Develop and approve uniform Methods of quality control for each type of diagnostic radiological equipment, which will include the parameters to be controlled, the frequency of control and tolerances, requirements for measuring equipment.
e) Improve the quality of control by the regulatory body.
e) Create an audit team (format to be considered) that will be able to provide professional competent support to the regulator.
f) Start using modern information technologies in the quality control system (online registers of licensed medical physicists, organizations that have the right to provide services for quality control procedures, online reporting on quality control procedures, etc.).
The above proposals, changes to them, as well as additional proposals should be structured into a general Concept with a long-term long-term plan, the implementation of which will be part of the state policy in the field of radiation protection and safety using ionizing radiation sources in medicine.
P.S. An article about the III Forum of Medical Physicists of Ukraine and Abstracts of the III Ukrainian Medical Physicists Forum were also published in the Radiological Bulletin.