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    Radiation Safety

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    This document discusses ensuring patient safety in radiation oncology. It outlines how organizations like ASTRO, AAPM, ACR, and AMA have established standards and protocols to prevent errors in radiation treatment by addressing both mechanical failures and human errors. These include quality assurance checks of radiation machines, accreditation requirements for facilities and staff, and collaborative reporting systems to learn from mistakes. While errors can still occur, increased awareness of safety issues and regulatory efforts have helped align the field with a culture of prioritizing patient safety.

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    Radiation Safety

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    This document discusses ensuring patient safety in radiation oncology. It outlines how organizations like ASTRO, AAPM, ACR, and AMA have established standards and protocols to prevent errors in radiation treatment by addressing both mechanical failures and human errors. These include quality assurance checks of radiation machines, accreditation requirements for facilities and staff, and collaborative reporting systems to learn from mistakes. While errors can still occur, increased awareness of safety issues and regulatory efforts have helped align the field with a culture of prioritizing patient safety.

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    This document discusses ensuring patient safety in radiation oncology. It outlines how organizations like ASTRO, AAPM, ACR, and AMA have established standards and protocols to prevent errors in radiation treatment by addressing both mechanical failures and human errors. These include quality assurance checks of radiation machines, accreditation requirements for facilities and staff, and collaborative reporting systems to learn from mistakes. While errors can still occur, increased awareness of safety issues and regulatory efforts have helped align the field with a culture of prioritizing patient safety.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    47 views3 pages

    Radiation Safety

    Uploaded by

    api-484027891
    This document discusses ensuring patient safety in radiation oncology. It outlines how organizations like ASTRO, AAPM, ACR, and AMA have established standards and protocols to prevent errors in radiation treatment by addressing both mechanical failures and human errors. These include quality assurance checks of radiation machines, accreditation requirements for facilities and staff, and collaborative reporting systems to learn from mistakes. While errors can still occur, increased awareness of safety issues and regulatory efforts have helped align the field with a culture of prioritizing patient safety.

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    © All Rights Reserved
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    of 3

    Alicia Wilson RT(T)

    DOS 516 Fundamentals of Radiation Safety


    Ensuring Patient Safety in Radiation Oncology

    Technology continues to change dramatically in all aspects of healthcare. Patients have


    access to an infinite amount of information regarding their treatment options, plan of care,
    medical provider backgrounds, hospital ratings, and error statistics. Access to this information
    plays an ever-growing role in where patients choose to have their treatment and the level of trust
    they feel toward their providers. Patient satisfaction is beginning to take on a monetary
    component as many reimbursements are being tied to patient satisfaction scores. With the
    publication of several reports and news articles concerning errors in medicine, regulating
    agencies recognize the importance of patients’ safety and subsequent satisfaction with their care.
    Trading fear of weakness for opportunity to learn has allowed better understanding of how and
    why errors occur in radiation oncology and stimulated the implementation of methods for
    prevention.1

    In response to the attention on errors in medicine, organizations like the American


    Medical Association(AMA), the American Association of Physicists in Medicine (AAPM), the
    American College of Radiology (ACR), and the American Society of Radiation Oncology
    (ASTRO) have joined forces to try to recognize areas prone to errors and create methods to catch
    these errors before they reach the patient.1 Earlier this year ASTRO published a revision to its
    2012 Safety is No Accident report, a book of standards and requirements making
    recommendations for staffing levels, roles and responsibilities, patient care standards, treatment
    planning principles, quality assurance methods, safety protocols, policies and procedures, and
    documentation requirements.2 Healthcare facilities have responded with a fresh awareness of
    patient safety and working hard to ensure they abide by the given recommendations at all times.

    Errors in medicine have two components to them, failures in mechanics (equipment and
    technology) and failures in humans. Understanding causative factors is necessary to establish
    effective and relevant tools to prevent error. To determine what safety standards to put in place
    that will address both the mechanical and human factors, we need to investigate and understand
    the cause, frequency, and impact of errors.3 Up until recently trying to record and track medical
    errors has been difficult, as they were not always well reported. Recently ASTRO developed a
    new tool named Radiation Oncology Incident Learning Systems (RO-ILS). RO-ILS is a
    collaborative reporting system designed for anonymous reporting, protected from litigation, to
    Ensuring Patient Safety in Radiation Oncology

    allow for the study of errors, the development of protocols and standards, and the pursuit of
    safety in radiation oncology.2 The hope is that with collaboration, radiation oncology centers
    nation wide will be able to learn from collective mistakes and develop a new culture of safety
    where all members of the team are invested in patient centered safe practices.

    To solve the problem of mechanical failures and errors, quality assurance metrics have
    been put in place by the AAPM’s Task Group 51 and the ACR. Task Group 51 developed
    standards for linear accelerator calibration and beam dosimetry. This set of standards ensures that
    all calibration equipment is routinely checked and corroborated, calibration and quality assurance
    procedures are done according to set standards, and machine outputs are verified against known
    calibration metrics.4 Patients can recognize that compliant radiation oncology facilities should all
    be operating with a high level of accurate machine performance.

    Quality assurance policies and procedures guarantee that machine performance is


    checked and evaluated daily prior to any patient treatments. Monthly quality checks are done at
    an even deeper level, and further annual checks validate that machine calibration and
    performance remain within compliance boundaries. All of these safety checks help prevent
    machine failures and errors. New linear accelerators even include their own internal safety
    checks to verify accurate machine output continually during treatment. Automatic beam shut offs
    pause the treatment if the machine parameters sway outside of set limits or if patient movement
    triggers the table sensors.

    Patients who choose an accredited organization can find comfort knowing these facilities
    must comply with all recommendations from the ACR and Joint Commission. These accrediting
    agencies address numerous aspects that could lead to human error. They offer guidelines for
    standard policies and procedures; treatment planning; chart review processes; chart rounds and
    peer review to assure treatment plans are viewed and discussed by multiple levels of staff prior to
    reaching a patient. Staffing levels and staff qualifications are mandated to guarantee two
    therapists are watching and treating a patient at all times. They dictate that therapists,
    dosimetrists, physicists, and physicians are adequately trained and licensed. They encourage
    internal studies of morbidity, mortality, and outcomes to maintain continued emphasis on quality
    of care.5 Accreditation agencies insist facilities provide a work environment conducive to safe
    practices, review patient treatments multiple ways and times, evaluate their operations regularly,
    Ensuring Patient Safety in Radiation Oncology

    and watch for ways to improve. This approach echoes the belief that the more eyes on the patient
    and their plan, the less opportunity for circumstances to align to allow errors through the cracks.3

    Errors are still possible, regardless of all the training, checklists, and procedures we put in
    place. Acknowledging our susceptibility to error, investigating the causes of error, and creating
    strategies to prevent future errors from occurring are the only ways healthcare safety standards
    will continue to be relevant and effective. While media publicity highlighting medical errors can
    scare patients, it has also opened the door for a new way of thinking toward patient safety. The
    awareness brought on by these media reports has caused us to acknowledge our weaknesses, and
    encouraged an ongoing pursuit of safe practices. With all of the information patients have access
    to, they can find peace in knowing healthcare has responded with a great collaborative effort to
    regulate quality checks and machine performance; ensure adequate staffing levels, work
    environments, and education; and standardize their care in order to align with a culture of safety.

    References:
    1
    Hendee, W.R, Herman, M.G. Improving patient safety in radiation oncology. AM. Assoc. Phys. Med.
    2011; 38(1): 78-82. https://aapm.onlinelibrary.wiley.com/doi/full/10.1118/1.3522875. Published December 14,
    2010. Accessed October 21, 2019.
    2
    American Society of Radiation Oncology [ASTRO] 2019. Safety is No Accident A framework for quality
    radiation oncology care.
    https://www.astro.org/ASTRO/media/ASTRO/Patient%20Care%20and%20Research/PDFs/Safety_is_No_Accident.
    pdf Accessed October 22, 2019
    3
    Marks, L.B., et al. The challenge of maximizing safety in radiation oncology. Pract. Radiat. Oncol.
    January-March 2011. Pages 2-14.

    Ibbott, G., Ma, C. –M., Rogers, D.W.O, Seltzer, S. M., Williamson, J. F., Anniversary Paper: Fifty years
    4

    of AAPM involvement in radiation dosimetry. AM Assoc. Phys. Med. 35 (4) April 2008 Pages 1418-1427
    5
    American College of Radiology. Radiation Oncology Practice Accreditation Program Requirements.
    Revised July 3, 2019.
    https://www.acraccreditation.org/~/media/ACRAccreditation/Documents/ROPA/Requirements.pdf. Accessed
    October 22, 2019

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