The independent progress,
overall effectiveness,
and unique priorities of each global patient radiation safety initiative were evaluated using a strengths,
weaknesses,
opportunities,
and threats (SWOT) analytical approach.
A SWOT analysis evaluates the internal and external variables that pertain to high-level organization and planning within the public health sector [4].
For the SWOT analysis ,
peer reviewed academic literature and grey literature were included.
The Web of Science and PubMed databases were used to obtain academic literature,
while high quality grey literature was obtained from websites and online articles. Furthermore,
the contributed papers from the 2017 IAEA "International Conference on Radiation Protection in Medicine: Achieving Change in Practice" were included.
This conference reviewed the development and progression of the global patient safety initiatives since 2012.
As such,
they provided valuable information for the SWOT analyses.
AfroSafe
The AfroSafe campaign was launched in 2015 and encourages stakeholders to promote radiation safety by adhering to the Bonn Call-for-Action standards,
policies,
strategies,
and activities in order to maximize the benefits of medical imaging modalities that utilize ionizing radiation [5].
Strengths
Because radiation health workers facilitated the development of the AfroSafe campaign,
there is motivation and support from healthcare professionals to implement radiation safety protocols and standards.
Futhermore,
the AfroSafe campaigns clearly outlines their goals and direction through their Matrix Tool Booklet [5].
Weaknesses
Although radiation health workers support the AfroSafe campaign,
it is acknowledged that there are still misconceptions in addition to a lack of awareness amongst healthcare professionals regarding the harm of ionizing radiation in medical imaging [6].
Additionally,
many African countries lack the proper medical imaging infrastructure and financial resources to support and implement the AfroSafe campaign recommendations [5].
Opportunities
Many countries in Africa are currently investing in the development of their healthcare sectors,
thus the political climate may be more supportive of the AfroSafe campaign [6].
Threats
The AfroSafe campaign faces economic,
political,
social and cultural barriers [5-6].
ArabSafe
ArabSafe is the most recent initiative as it was established in 2017.
It aims to promote radiation safety culture throughout the Arab region,
support self-regulation,
and increase radiation safety awareness by engaging patients,
healthcare professionals,
and the general public [7].
Strengths
The implementation of national chapters of the ArabSafe group suggests there is significant support from the Arab medical radiation community and enables each chapter to cater their goals and priorities to the needs of their region.
Weaknesses
Because the ArabSafe group was only recently established,
it is still in the early stages of development and implementation [7].
Opportunities
There is an opportunity for the ArabSafe group to benefit from the knowledge and expertise of more established initiatives.
Threats
As the newest global radiation safety initiative,
there may not be immediate changes in everyday patient care.
Canada Safe Imaging
Canada Safe Imaging is a multidisciplinary and collaborative initiative that aims to improve radiation safety awareness amongst Canadian healthcare professionals while establishing evidence-informed national guidelines [8].
Strengths
Canada Safe Imaging has a wide range of representation from stakeholders including government agencies,
professional associations,
universities,
research institutions,
hospitals,
and the private sector resulting in a holistic approach to patient radiation safety [8].
Weaknesses
This initiative has been slow to gain momentum due to insufficient financial and human resources [8].
Opportunities
This initiative has the potential for large scale implementation of national guidelines.
Threats
In Canada,
healthcare regulation and delivery are the responsibility of each independent province,
thus,
forming a national strategy will require significant political support.
EuroSafe Imaging
The EuroSafe Imaging alliance uses a comprehensive approach to promote medical radiation protection,
quality,
and safety across Europe [9].
Strengths
The EuroSafe Imaging alliance has significant support and representation from a wide array of medical radiation professional associations across Europe with clear action items modeled after the Bonn Call-for-Action [9].
Weaknesses
There appears to be a disconnect in patient and public engagement with regards to patient radiation safety.
Opportunities
Due to the strength of the EuroSafe Imaging alliance,
they are able to provide valuable insights and expertise for new initiatives.
Threats
The overall clinical focus of the EuroSafe Imaging alliance may discourage public engagement.
Image Gently
Image Gently promotes safe pediatric imaging in the United States while providing education on the use of ionizing radiation in medical imaging to patients,
their families,
and healthcare professionals [10].
Strengths
The Image Gently alliance is well structured and has effective governance.
They also receive annual financial and human resource support from a variety of professional associations [10].
Weaknesses
It is not explicitly stated how the Image Gently alliance campaigns align with the Bonn Call-for-Action recommendations.
Opportunities
Because the Image Gently alliance is well established,
they have the opportunity to provide expertise to new initiatives and develop a large-scale outreach educational project targeting the misconceptions regarding ionizing radiation in medical imaging.
Threats
Although many threats have already been addressed,
there are still many misconceptions amongst parents regarding the use of ionizing radiation in medical imaging with children.
Image Wisely
Image Wisely promotes awareness and education to patients and healthcare professionals regarding ionizing radiation and exposure in the United States while advocating for the elimination of unnecessary medical imaging procedures [11].
Strengths
Image Wisely has a strong internal structure and governance with an engaging website and strong social media presence [11].
Weaknesses
The information provided by Image Wisely is largely targeted for healthcare professionals rather than the general public.
Opportunities
Similarly,
Image Wisely can provide expertise on the development of new global patient radiation initiatives.
Threats
Because the executive committee consists of volunteers,
it may be difficult to recruit professionals to manage and drive the initiative.
Japan Safe Imaging
Japan Safe Imaging aims to enhance the distribution of medical radiation equipment while monitoring and managing radiation doses and promoting medical imaging standardization,
optimization,
and justification [12].
Strengths
Japan Safe Imaging receives significant financial resources and political support [12].
Weaknesses
Information on the goals of the Japan Safe Imaging initiative is difficult to find as there is no central area to disseminate information.
Opportunities
There is significant raised public awareness regarding ionizing radiation and patient safety since the Fukushima incident [12].
Threats
The Japan Safe Imaging initiative faces a unique challenge in changing medical imaging culture given the abundance of CT imaging resources.
LatinSafe
The LatinSafe alliance advocates for the radiological protection of patients in medical imaging throughout Latin America by following the Bonn Call-for-Action [13].
Strengths
The LatinSafe alliance has a wide representation of stakeholders with a strong focus on increasing ionizing radiation awareness and education.
They also provide information in both Spanish and Portuguese [13].
Weaknesses
The LatinSafe alliance has implemented various strategies,
however it is difficult to determine the success of these strategies as the data is currently unavailable.
Opportunities
There is an opportunity for evidence-informed information to be disseminated to both private and public health authorities.
Threats
Current threats include the lack of radiation protection culture that exists,
as well as the lack of available funding for further programming [13].