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.