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National Radiology Services Operational Policy

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National Radiology Services Operational Policy N A T I O N A L R A D I O L O G Y S E R V I C E S O P E R A T I O N A L P O L I C Y NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY MINISTRY OF HEALTH MALAYSIA NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY Clinical Support Services Unit Medical Development Divison Minitry of Health Malaysia NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY First Edition 2019 Efforts were coordinated by Clinical Support Unit, Medical Services Development Section Medical Development Division Ministry of Health, Malaysia. A catalogue record of this document is available from the Library and Resource Unit of Institute of Medical Research, Ministry of Health; MOH/P/PAK/427.19 (BP) And also available from National Library of Malaysia; ISBN 978-967-2173-78-6 © Ministry of Health Malaysia 2019 All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the Ministry of Health Malaysia. Published by : Medical Development Division Ministry of Health, Blok E1,Parcel E, Federal Government Administrative Center, 62590 Putrajaya, Malaysia. Tel : 603-88831489 Fax : 603-88831155 http://www.moh.gov.my Page 2 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY This policy was developed by the Medical Development Division and the Drafting Committee of Operational Policy on Radiology Services Ministry of Health Malaysia. Page 3 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY ACKNOWLEDGEMENT The completion of this National Operational Policy on Radiology Services could not have been possible without the participation and assistance of the Drafting Committee of Operational Policy on Radiology Services. Their contributions are sincerely appreciated and gratefully acknowledged. Page 4 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY Page 5 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY FOREWORD Director General of Health Malaysia 8 Former National Advisor on Radiology Services . 9 National Head of Radiology Services 10 LIST OF ABBREVIATIONS 12 CONTENT: 1.0 ORGANISATION & MANAGEMENT 13-15 1.1 Vision 1.2 Mission 1.3 Objectives 1.4 Scope of Service 1.5 Organisational Structure 2.0 OPERATIONAL POLICY 16-21 2.1 General Statement 2.2 Scheduling an examination 2.3 Special Examinations 2.4 Mammography 2.5 Interventional Radiology 2.6 Peripheral Radiology Services 2.7 Forensic Radiology 3.0 PATIENT CARE 22-23 4.0 REPORTING, CONSULTATION & 23 IMAGE MANAGEMENT 5.0 SAFETY IN IMAGING 24-33 5.1 Radiation Safety 5.2 Examination on Females of Child Bearing Age 5.3 MRI Safety 5.4 Contrast Media Safety 5.5 Infection Control 5.6 Occupational Safety 5.7 Chemical Waste Management 5.8 Incidents in the Radiology Department Page 6 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY 6.0 PATIENT’S RIGHTS 34 7.0 TRAINING / CONTINUOUS 34 PROFESSIONAL DEVELOPMENT (CPD) 8.0 FACILITIES AND EQUIPMENT 35-39 8.1 General 8.2 Facilities 8.3 Equipment 8.3.1 Safety and Performance 8.3.2 Storage / Security and Maintenance of Mobile X-ray Equipment 8.3.3 Contingency Plan for Equipment / System Failure 8.3.4 Decommissioning 9.0 APPENDIX 40-63 Page 7 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY In the wake of the Fourth Industrial Revolution, healthcare services all around the globe will not be spared of the Internet ripple, and radiology will be at the forefront of the wave of Artifical Intelligence and the Internet of Things. As one of the earliest adopters of X-ray technology in 1873, Malaysian healthcare system will once again be tested. Tremendous development of imaging modalities that utilises ionizing radiation such as CT and X-ray, magnetic resonance imaging and ultrasound in recent years provides clinicians with even more information with precise accuracy. Our physicians are now able to expedite clinical decisions, hence enable us to yield an improved quality of care to our patients. Malaysian healthcare system is often antagonised with economic inflations and constrains of limited resources. Routinely, high degree of co-ordination for advanced imaging are required in assisting clinicians’ diagnosis as well as radiological therapeutic interventions. Henceforth, the birth of this policy is hoped to provide guidance to relevant parties on a development of a system that is financially viable, coordinated and efficient. The use of radiation is governed by complex regulations and license condition therefore it is impartial that the management and healthcare providers to continue to embrace initiative designed to response and complement to these challenges and abide to the policy promulgated. Therefore, it is our professional responsibility to carry out the delivery of safe and effective practice. Finally, I would like to congratulate the Medical Development Division for amalgamating this effort and commendation must belong to the drafting committee led by Datin Dr Zaharah Musa for their continuing dedication and commitment. I believe that this commitment will continue safeguarding Ministry of Health’s mission to provide the country with an unsurpassable healthcare system into the 21st century. Datuk Dr. Noor Hisham Abdullah Director General of Health, Malaysia Page 8 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY Radiology has become an integral component of modern medical patient care. a has grown in leaps and bounds since the discovery of X-rays in 1895 and Malaysia was at the forefront of the medical radiology when the first x-ray machine in Malaysia was installed in Taiping Hospital in 1896. The scope of service today has expanded from basic radiography to include modern sophisticated radiological equipment and applications. The service now has progressed into therapeutic realm with the evolution of interventional radiology. Modern medicine in the 21st century has recognized the value of radiology and its use is now extended into forensic radiology where vigorous research is ongoing worldwide to assess its role in converting open autopsy to virtual autopsy. As radiology continues to progress in this era of disruptive technology, our focus must pivot on patient care. Precedence of quality patient care in our service also means, every member of the radiological department must work effectively together to provide high-quality and time-efficient patient imaging whilst ensuring the safety of the medical personnel and patients alike during the radiological procedure. The publication of this policy is timely, and it is aimed at setting out the principles and arrangements which we believe are appropriate for high-quality patient care. It is hoped that this document will assist and guide radiological and non-radiological staff alike to understand our work processes better and hence able to optimize its usage in patient care. The Medical Development Division, Medical Radiation Surveillance Division, Family Health Development Division as well as Engineering Division has provided enormous support in the preparation of this document and I am grateful for their guidance and assistance. I would also like to thank my seniors and colleagues in the drafting committee who developed this document and all those who have also helped one way or another. Datin Dr. Zaharah Musa Former National Advisor on Radiology Services . Page 9 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY This National Radiology Services Operational Policy document was initiated by my predecessor, Datin Dr Zaharah Musa. The aims of this policy document are to establish guidelines and best practices in our organisation. It is hope that this policy document will serve as a reference standard among the radiology service providers and the end users in order to provide quality and safe practice. As the radiological fraternity is on the verge of a major revolution in medicine with the advent of artificial intelligence (AI) we should be actively involved in shaping our own future and warrant that we will be the fittest to survive natural selection. Radiologists need to expand their role and show value in order to remain relevant in clinical practice in the era of AI. Radiologists must go beyond detecting lesions and interpreting images because machines already perform these tasks better than humans. The radiologists role will rather be to answer clinical questions by integrating the imaging information together with clinical information and putting it all in context. Radiologists must include more information in their reports from genomics and fields other than imaging, and not just give recommendations This document will not be complete without the contribution and commitment from the drafting committee and for that I would like to express my gratitude. I hope that this document can be put to good use to raise the bar of radiology service in the Ministry of Health Malaysia. Dr. Yun Sii Ing National Advisor on Radiology Services 2018– present Page 10 NATIONAL RADIOLOGY SERVICES OPERATIONAL POLICY Definition Special Examination Refers to all other forms of imaging other than general radiography (X-ray) Peripheral Radiology Services Refers to the provision of trained radiology personnel to handle imaging modalities in other departments. Satellite Services Refers to the provision of radiology servicesin areas other than the main department. Interventional Radiology Refers to the utilization of minimally invasive image guided procedures to diagnose and treat diseases. Forensic Radiology Refers to the application of imaging on a deceased person and / or body parts to questions of law. Radiology Consultation
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