Interventional Radiology: moving on from the troublesome teens

Iain RobertsonPresident British Society of Interventional Radiology

Consultant Interventional RadiologistGreater Glasgow & Clyde Health Board

Email: bsiriain@gmail.com

History of IR

1966

1972 1987

1991

2010

UK Interventional Radiology

• Founded 1988

• 633 members

• 490 members

• 140 junior members

• 2 associate members

Identity &

Responsibility

Vital, clinical service of proven effectiveness

• National Imaging Board Report

• NICE/ MHRA/ DOH

• RCR

• Chief Medical Officers

What is an Interventional Radiologist?

Internal Identity

External Identity

• Subspecialist accreditation

• Defined curriculum

• Defined training pathway

• 3 years core

• 3 years IR

• Defined assessment

Dependability(Responsibility)

How do we know a good quality IR service?

Vital means dependable 24/7

Clinical means patient focused

Proven effectiveness means

data driven

RAG status

• Core 24/7 services

• England only just

now

• Map revision March

2012

Key Steps

1. Define the scope of services2. Define staff involvement3. Procedures manual4. Unify equipment5. Embobags

Scope of services

Key Steps: Scope of service

• Range of procedures appropriate for sites• Understand what is done in hours• Understand what you aim to do out of

hours• Set a defined target: hemorrhage control

for most of us• Define sites that will participate and how

Make new friends

Upskill new friends as reqd

Set the bar

•EVAR Primary operator: 4

•TIPPS Primary operator: 5

•Embolization: 9

•Nephrostomy around 15

1:6 is the minimum target

Radiology Teams

Hard Facts

If you won’t do it OOH – you don’t do it in hours!

Nurses

• Need nurse leadership

• Longer negotiation

• Cross-city service

• Staff rotation for training

• Reduce variability -Protocols

• Develop a manual

Procedures manual

• Defines service

• Referral process &

responsibilities

• Site specific info

• Protocols

• Equipment lists

Unify equipment stock

• Everyone uses the same

• Supports the nurses/

radiographers

• Provides resilience

• Saved the hospital 150K

• Responsible control

Embobags

• “Portable” consumables

• 2 embo bags

• Catheters

• Embolics

• Contrast

• Needles

• Everything……….

www.bsir-qi.com