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ESR/EFRS - Patient safety in medical imaging
Education EuroSafe Imaging Medico-legal Professional Issues Physics in Medical Imaging
Saturday, March 2, 16:00 - 17:30
Room: C
Type of session: Joint Session of the ESR and EFRS
Topic: Education, EuroSafe Imaging, Medico-legal, Professional Issues, Physics in Medical Imaging
Moderators: A. Brady (Cork/IE), J. McNulty (Dublin/IE)

EuroSafe Imaging and the European Basic Safety Standards Directive: progressing patient safety
G. Frija; Paris/FR
Learning Objectives

1. To explore the aims and objectives of EuroSafe Imaging and its achievements to date.
2. To appreciate aspects of the Basic Safety Standards Directive, which will further progress patient safety.
3. To consider what the future holds for EuroSafe Imaging.


EuroSafe Imaging is the European Society of Radiology’s flagship initiative for promoting quality and safety in medical imaging. Launched in 2014, EuroSafe Imaging leads numerous activities to support and strengthen medical radiation protection across Europe through the implementation of the 13 actions of its Call for Action 2018. Among other activities, EuroSafe Imaging has provided guidance and practical tools to support compliance with the European Commission Directive 2013/59/Euratom (“Basic Safety Standards Directive”), which lays down basic safety standards for protection against the dangers arising from exposure to ionising radiation. It entails substantial new requirements in various areas, e.g. improving the protection of patients in medical imaging procedures, improving the protection of workers, and improving the protection of the public in particular from natural radiation sources. The Directive entered into force in February 2018. This talk will present the EuroSafe Imaging initiative, its achievements to date and future activities. Moreover, it will provide an overview of the BSS Directive and its contribution to promoting patient safety in medical imaging.

Patient safety: beyond radiation protection
K. B. Azevedo; Faro/PT
Learning Objectives

1. To appreciate the scope of patient safety related to medical imaging services.
2. To consider a selection of examples of patient safety beyond radiation protection, optimisation and justification.
3. To explore the important roles of radiographers and radiologists in working collaboratively to best ensure patient safety.


Patient safety is a broad field of knowledge and intervention and can be divided into three domains namely: structural factors; processes; and outcomes. Medical imaging services receive a considerable number of patients every day that undergo several number of different procedures. It is important to highlight that each procedure has a potential to cause harm to the patient and this potential is present even before the first contact with the patient and ends after the last contact with the patient. It is clear that the leading objective of an imaging service is to diagnose and treat the patient, but at the same time do no needless damage. To increase patient safety the first step is to make it an institutional cultural theme. Beyond radiation-related issues, patient safety can be affected by the importance given by the management to this subject, communication, feedback and non-punitive response to error, adequate staffing, infection control, adequate continuous professional development, handoffs and transitions, and teamwork in the imaging service and with other units, such as inpatient wards, and the imaging services. The radiographer and the radiologist are key elements in the medical imaging services. To receive and prepare the patient, to perform the exams, from their programming, their execution, their quality evaluation and to diagnose and treat the patient, there are several factors that may influence patient safety, not only at the imaging service level but also at the whole healthcare institution level.

Value-based imaging and patient safety
A. Brady; Cork/IE
Learning Objectives

1. To learn about the developing model of value-based healthcare.
2. To appreciate how and why radiology should be included in this model.
3. To understand how this may impact upon patient safety.


The value-based healthcare concept is growing in importance, as part of a trend away from concentration on the delivery of volume-based services, and towards concentration on the specifics of delivering value-based care to individuals and the population as a whole. The components of what constitutes value differ among physician, provider and patient groups, and thus the parameters of value in healthcare are not fixed. The original model of value-based healthcare began consideration of value at the point when a patient received a diagnosis; the impact of radiology was effectively excluded, given that much of the work of radiology departments are geared towards arriving at a diagnosis in the first instance. This talk will focus on this “classical” model, and explore how and why it should be varied to include the impact of radiology on delivering value-based healthcare to patients. The impact of considering the value of radiology in patient care regarding ensuring patient safety will be explored.

Patient safety related education and training
J. McNulty; Dublin/IE
Learning Objectives

1. To emphasise the importance of education and training in progressing patient safety in medical imaging.
2. To consider the current status of patient safety in radiography and radiology curricula.
3. To appreciate the activities of the EFRS and ESR in the area of patient safety education and training.


Patient safety is a major priority for all healthcare professions and one of the biggest areas of public focus. There is no question that embedding the theme of patient safety in undergraduate medical and radiography curricula, together with making it a core part of all postgraduate or specialist education and training, has the potential to improve patient safety. While there has been a lot of focus on this in terms of other professional groups, there is a lack of information regarding the inclusion of patient safety topics within undergraduate radiography curricula or indeed within radiology training programmes. Radiographers and radiologists encounter numerous patient safety issues which stretch far beyond the area of radiation protection. The responsibilities of radiographers and radiologists overlap substantially across most areas; thus team-working within the medical imaging environment is key to ensuring a safe environment for our patients. Recent evidence from the European Federation of Radiographer Societies (EFRS) demonstrated that patient safety is a deeply embedded concept within undergraduate radiography curricula across Europe, however, variations, some of which are significant, do exist in terms of the topics covered, the teaching and assessment methods, and the depth or level in which subjects are taught. This presentation will explore aspects of patient safety-related education and training for radiographers and will highlight the current opinions of the ESR and EFRS in this regard.

Patient perspectives on patient safety in medical imaging
E. Briers; Hasselt/BE
Learning Objectives

1. To understand what patients feel about patient safety in medical imaging.
2. To appreciate the value of active engagement with patients to enhance and promote patient safety.
3. To consider initiatives to implement patient-engagement at the institutional or national level.


Safety for patients in medical imaging is linked to the department of “Medical Imaging - Radiology”. It depends on several elements, there is the “why” they are there, the “what” will happen, the “how” does this work and the other personal but important aspects to be in a new environment. Safety has by itself different “imaging” aspects, and there is the radiation, the eventual contrast, the small space, the length of time of being unable to move and others, all of these are important but shall be offset versus the “why” the patient is there. The patient will balance some of the known facts (to him) and associated safety risks versus the risks of having a disease that may or may not cause him a big quality of life loss. The risk taken should be in relation to the expected benefit. A repeated CT-scan for lung cancer looks quite different from a CT-scan for a common cold which no-one would do. The information that the patient needs to be able to weigh the risks versus the benefit should come from multiple sources, the medical team is multi-professional, and all can contribute. They should explain each for his part how the (not yet confirmed) disease could evolve and what the benefit of the final diagnosis would be. On the risk side, careful listening to the patient and taking note of previous experiences in imaging and beyond, allergies, psychological issues with confined spaces, being very young or old, all matter and can influence the procedure taken.

Panel discussion: The role of the ESR and the EFRS in promoting patient safety
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