Safety for patients and staff is of vital concern for imaging and radiation oncology professionals and a key area of expertise for the BIR.
In 2017 we decided that the main focus of our policy and campaigning efforts for the following five yearswould be related to the safety of patients and staff. We launched the BIR Safety Campaign as a way of bringing this activity together. Below is an outline of some of the work we have done so far.
Our activity falls under three main categories, which are often overlapping:
Leading and participating
We lead or participate in a number of multi-agency boards and working parties, including:
• BIR-led working party: Guidance on using shielding on patients for diagnostic radiology applications
• CLIPS Committee for Liaison with IRPA and Partner Societies
• CQC-led working party: Defining significant events
• HSE review group for REPPIR:Radiation (Preparedness and Public Information) Regulations revision
• IPEM-led working party: Communicating risk and benefit to patients and comforters and carers
• PHE National Dosimetry Working Party
• RCR-led working party: Revision of IR(ME)R guidance for radiology
• RCR-led working party: IR(ME)R audits in radiology
• Representation at the International Radiation Protection Association annual meeting
The BIR periodically takes part in consultations and regulation reviews, such as the Health Safety Executive (HSE)’s consultation on IRR 2017 and the Department of Health consultation on IR(ME)R 2017.
Ground breaking new patient shielding guidance
In 2017 the BIR launched a working party to review and provide guidance on using shielding on patients for diagnostic radiology applications. The group meticulously researched the subject, collecting evidence that showed that some of the practices common for the past 70 years are less safe than they could be. As a result the group issued a joint report of the British Institute of Radiology, Public Health England, Institute of Physics and Engineering in Medicine, Society and College of Radiographers Royal College of Radiologists, and the Society for Radiological Protection. It provided evidence-based guidance on why contact shielding for patients is no longer needed during most X-rays, CT scans and interventional radiology.
An executive summary has also been published:
We produced an A4 double-sided flyer which explains the guidance to patients:
Radiation Safety Special Feature September 2021
Contemporary issues in radiation protection in medical imaging special feature
Radiation Safety Week
In 2019 the BIR launched Radiation Safety Week. Each year we provide useful information and guidance to help professionals work more safely, and we use social media and other channels to raise awareness and remind people of the importance of radiation safety.
MR Safety Week
MRI Safety Week marks the anniversary of the tragic 2001 MRI accident that resulted in the preventable death of Michael Colombini, age 6, who died when a portable steel oxygen cylinder was brought into the MRI room during his MR scan. Each year we participate in the effort to raise awareness of MR Safety and help equip professionals with the information they need to work safely.
Monitoring confidence in PPE and essential supplies during the COVID-19 emergency
Towards the beginning of the COVID-19 emergency we received a number of reports from members that frontline imaging and oncology professionals, especially radiographers and sonographers, did not have confidence they were receiving adequate protection or supplies to operate safely. In April 2020 we conducted a survey of imaging and oncology professionals. The results showed that only a minority of the 561 radiographers surveyed thought that the provision of COVID-19 PPE, testing or cleaning supplies, equipment or cleaning staff was adequate where they worked for people in their role. Responses from sonographers, scientists and medical professionals was also concerning. Our results were widely publicised and we repeated the exercise a month later. These results showed a significant increase in confidence across all the professions surveyed.
BIR/GE Radiation Safety Award
To help raise awareness of radiation safety across the professions the first BIR/GE Radiation Safety award was presented in 2017. This funds the recipient to travel to a radiation safety conference of their choice to present their work in the form of a presentation or poster. Thank you to GE Healthcare for supporting this award.
Radiation Safety 2021 – a major new online video course for the imaging team
In October 2021 we launched a major new video course, Radiation Safety 2021, for the whole imaging team including radiographers, physicists, radiologists and employers. Engaging, memorable and relevant, each course contains around 3 hours of video, divided into approximately 20 minute sessions, plus test questions, materials, and a CPD certificate. It includes illustrations, animation, live action, recorded interviews and interactive questions, viewable in bite-sized sessions at any time on any device.
Radiation Protection for Cardiology e-learning course via eLfH
Developed by the British Institute of Radiology in collaboration with representatives from the Royal College of Physicians’ Specialist Advisory Committee in Cardiology, scientists involved in the delivery of radiation protection courses for cardiologists, clinicians, radiographers and Health Education England e-Learning for Healthcare. The course consists of six 30 minute sessions:
Radiation Protection for Vascular Surgeons e-learning course via eLfH
Designed to increase awareness and knowledge amongst the vascular surgery community of the hazards associated with exposure to ionising radiation. The programme, developed in collaboration between the BIR and Health Education England, takes into account the latest changes in safety legislation, is aimed at vascular surgery trainees and will also benefit more experienced surgeons.
The BIR has hosted a large number of in-person and online events on radiation safety and MR safety events. Recorded events can be found by visiting the BIR Online Learning Library: https://www.mybir.org.uk/BIR_Content?page=a0M0O000015n9N7UAI&site=a0N2000000COvFsEAL
Annual radiation safety/IR(ME)R meeting
Each year the BIR hosts the major annual event on current practice and the direction of flow relating to radiation safety and compliance with the Ionising Radiation (Medical Exposure) Regulations IR(ME)R. This is a multi-disciplinary forum which serves as a key educational and networking event for those interested in making sure their work, and that of their colleagues, remains safe and compliant with the applicable rules.
Interventional radiology nurses’ study day
Along with our events for radiographers, radiologists, oncologists and scientists, in 2019 we launched a very successful new event for nurses involved in interventional radiology, with a strong emphasis on radiation safety. A second, virtual, event is in preparation.
Guidance and position papers
The BIR’s Radiation Safety Special Interest Group and MR Special Interest Group have issued a number of position papers and guidance documents to help professionals work safely and in line with the latest thinking and regulation. This includes:
Guidance on using contact shielding on patients for diagnostic radiology applications
Guidance for non-medical referrers to radiology
Diagnostic radiological equipment installation and replacement guide
BIR position statement on purchasing of lead aprons
The BIR MR Safety Working Party has developed generic risk assessments to help sites with complying to the Management of Health and Safety at Work Regulations 1999. These can be adapted by users to fit with their own setting.
Books and journal papers
Hundreds of papers on safety topics have been published in the BIR’s journal titles: BJR, BJR|Open, BJR|Case reports, and DMFR. We have also published books on radiation protection, personal protective equipment, radiation shielding, and related subjects.
Podcasts on safety topics are hosted by the major podcast providers and available from the BIR Publications website: https://www.birpublications.org/page/podcasts
These include, for instance, https://www.birpublications.org/page/podcasts/2020/bjr125-radiation-protection and https://www.birpublications.org/page/education-podcasts/2017/mri-safety-week
BIR Sharing Platform
The BIR Sharing Platform is a growing library of resources which provides a range of examples and templates that have been used in practice by other professionals. To date 73 safety related templates or documents have been shared by BIR members for use by other BIR members, in an effort to share knowledge and best practice.