Planning and implementation of clinical audits in a medical physics department

With advances in medical technology, the use of diagnostic imaging and therapeutic procedures has significantly increased. This has resulted in an increase in total population exposure to medical radiation, up to exceeding the natural background dose, so implying an increased cancer risk. For this reason, it is important to improve and maintain a high quality of medical use of radiation. A tool implemented with this aim is the clinical audit, which has become relevant in medical radiological practice with the Council Directive 2013/59/EURATOM. In Italy, compliance with the MED directive is actuated by the Legislative Decree 101/20 in which the requirement on the implementation of the clinical audit appears in Art. 168, which states its actuation within four years from the effective date of the decree. Starting from this point, the first goal of this thesis is to assess the feasibility of the implementation of a clinical audit in the Medical Physics field. Once we had proved that, according to deep literature research, we developed four quality indicators that represent the basis of a potential audit realization. They form a framework that has been applied to the Medical Physics OU of IRCCS Azienda Ospedaliero-Universitaria di Bologna as an implementation example, but it can be used as a guide for other healthcare facilities looking to establish an effective audit process to enhance their services quality. The thesis resulted in the development of a comprehensive framework for an internal and/or external clinical audit that involves audit criteria identification and the development of checklists to ensure that all essential aspects are covered. It also highlights the importance of collaboration among healthcare professionals involved in the process. This work represents an important and innovative aspect of medical radiological practice and it is a starting point for the implementation of the clinical audit in this field within the National Healthcare System.