Radioprotection maturity in nuclear medicine: A structured KPI assessment framework

Nuclear medicine uses unsealed radioactive sources, creating radioprotection challenges that span governance, patient optimisation, occupational monitoring, contamination control, and radioactive waste/public protection. A structured questionnaire-based KPI approach can support systematic assessment of radioprotection maturity across these domains.

We developed a structured questionnaire-based KPI assessment framework for nuclear medicine radioprotection. The framework was operationalised into a predefined KPI dictionary covering governance and training, patient protection and optimisation, occupational protection, contamination control, waste/public protection, and incident learning/improvement. Questionnaire items were designed to capture binary, categorical, and continuous indicators using consistent definitions and reference periods.

The questionnaire structure suggested variability in management maturity, with stronger emphasis on role designation and basic radiation protection arrangements than on formalised quality management systems. Training and induction items indicated moderate but uneven maturity, suggesting that workforce preparation may require clearer standardisation. Patient optimisation appeared comparatively well represented, particularly through administered-activity benchmarking, although pregnancy and breastfeeding screening remained an important gatekeeping area requiring more consistent formalisation. Therapy-related questionnaire items suggested stronger attention to post-therapy instructions than to fully documented release procedures. Occupational protection responses indicated generally established dosimetry arrangements, with technologists appearing as the staff group most exposed by workflow proximity, while extremity and eye monitoring remained less consistently incorporated. Incident learning emerged as the least mature domain, with limited formal reporting structures, weak external learning participation, and slower corrective-action feedback loops. Overall, the qualitative pattern indicates that routine technical controls were better represented than structured governance, documentation, and learning-system maturity.

A structured questionnaire-based KPI framework can help nuclear medicine services review core infrastructure, patient optimisation, gatekeeping protocols, occupational monitoring, contamination control, waste/public protection, and incident learning. The framework provides a practical basis for generating measurable safety-system improvement plans aligned with international radiological protection expectations.

Nuclear medicine uses small amounts of radioactive materials for diagnosis and treatment, which requires careful safety measures. This study developed a structured checklist to review how well nuclear medicine services manage safety across areas like staff protection, patient care, and waste handling. This study found that basic safety practices were generally in place, but systems for management, documentation, training, and learning from incidents were less developed. This matters because clearer standards and stronger safety systems can help protect patients, staff, and the public more effectively.