Development of a Radiation Safety Management System for Healthcare Personnel and Patients at Wang Saphung Hospital, Loei Province, Thailand: A Research and Development Study

Abstract

Wang Saphung Hospital provides diagnostic radiology in the radiology department and in units using mobile X-ray equipment, involving staff from several professions, but no hospital-wide radiation safety management system linked these units.

        Objectives to (1) assess the situation, problems and needs, (2) develop and appraise the appropriateness of a radiation safety management system (3) evaluate outcomes after implementation.

        A three-phase research and development study (R1–D1, R2, D2) was conducted from August 2025 to July 2026.. Participants were all 36 staff involved in radiation use, 140 patients assessed before implementation and a separate group of 140 patients assessed after implementation, and three experts. Instruments were a situation and needs questionnaire, a knowledge test, an attitude questionnaire, a practice assessment form, a patient satisfaction questionnaire, an observation form for compliance indicators, and a system appropriateness form (IOC 0.67–1.00; KR-20 = 0.82; Cronbach's alpha 0.88–0.92). Data were analysed with descriptive statistics, Staff outcomes were analysed using paired-samples t-tests, whereas patient satisfaction was compared between the two independent patient groups using independent-samples t-tests, with 95% confidence intervals.

        The developed system comprised three major components: clinical practice guidelines and an operational manual, a personnel training programme, and monitoring and evaluation tools. Experts rated the overall appropriateness of the system at the highest level (Mean = 4.64, SD = 0.37). Following implementation, staff knowledge increased from 12.86 ± 2.14 to 17.94 ± 1.56 (mean difference 5.08, 95% CI 4.25–5.91, p < .001), attitude scores increased from 3.42 ± 0.46 to 4.38 ± 0.39 (mean difference 0.96, 95% CI 0.77–1.15, p < .001), and practice scores increased from 3.31 ± 0.51 to 4.29 ± 0.42 (mean difference 0.98, 95% CI 0.78–1.18, p < .001). Overall patient satisfaction was higher in the post-implementation group than in the pre-implementation group (4.47 ± 0.35 vs 3.59 ± 0.46; mean difference 0.88, 95% CI 0.78–0.98, p < .001). Compliance percentages increased across all five monitored indicators.

        Experts judged the developed system to be highly appropriate. Staff knowledge, attitudes, and self-reported practices, patient satisfaction, and compliance indicators were higher after implementation. Because the staff evaluation lacked a concurrent control group and several outcomes were self-reported, these findings should be interpreted as post-implementation changes rather than definitive evidence of causal effectiveness or improved radiation safety.