Radiation Safety Culture in Health Care: Canadian Perspective

1. Radiation Safety Culture in Health Care: Canadian Perspective Dave Wilkins, PhD, FCCPM Canadian Organization of Medical Physicists Ottawa, Canada

2. Regulatory Landscape for Radiation in Medical Sector in Canada • Canadian Nuclear Safety Commission (CNSC) regulates the use of radioactive material across Canada • In medical sector, CNSC regulates nuc med, brachytherapy, linacs above 10 MV, not X-Ray • CNSC mandate is limited to staff, public, environment – not patients • X-Ray safety is regulated provincially – large variation between provinces, some very poor

3. Staff dose is a solved problem

4. Patient Safety/Quality • Need to shift focus from radiation safety of staff and public, to patient radiation safety • Patient radiation safety and quality of treatment/diagnosis are two sides of the same coin • Regulatory framework in Canada is poorly structured for this shift • Rely on professional societies, education, and shift in culture

5. Canadian Patient Safety/Quality Initiatives • Canadian Partnership for Quality Radiotherapy (CPQR) – an alliance among: Canadian Organization of Medical Physicists (COMP) Canadian Association of Radiation Oncologists (CARO) Canadian Association of Medical Radiation Technologists (CAMRT) Canadian Partnership Against Cancer (CPAC) • Various initiatives, including technical quality standards for radiotherapy

6. Canadian Patient Safety/Quality Initiatives • COMP Winter School: Quality and Safety in Radiotherapy #1 January 2010, Banff, Alberta #2 February 2011, Mt. Tremblant, Quebec #3 February 2012, Whistler, BC • National Audit Program for radiotherapy centers (early stages) • National incident reporting system (in development) • Database for tracking patient doses from diagnostic procedures (in development)

7. Radiation safety professionals in the health care sector need to shift emphasis from staff dose to patient dose.