The impact of new technologies on radiation oncology events and trends in the past decade: an institutional experience Journal Article

Authors: Hunt, M. A.; Pastrana, G.; Amols, H. I.; Killen, A.; Alektiar, K.
Article Title: The impact of new technologies on radiation oncology events and trends in the past decade: an institutional experience
Abstract: To review the type and frequency of patient events from external-beam radiotherapy over a time period sufficiently long to encompass significant technology changes. Ten years of quality assurance records from January 2001 through December 2010 were retrospectively reviewed to determine the frequency of events affecting patient treatment from four radiation oncology process steps: simulation, treatment planning, data entry/transfer, and treatment delivery. Patient events were obtained from manual records and, from May 2007 onward, from an institution-wide database and reporting system. Events were classified according to process step of origination and segregated according to the most frequently observed event types. Events from the institution-wide database were evaluated to determine time trends. The overall event rate was 0.93% per course of treatment, with a downward trend over time led by a decrease in treatment delivery events. The frequency of certain event types, particularly in planning and treatment delivery, changed significantly over the course of the study, reflecting technologic and process changes. Treatments involving some form of manual intervention carried an event risk four times higher than those relying heavily on computer-aided design and delivery. Although the overall event rate was low, areas for improvement were identified, including manual calculations and data entry, late-day treatments, and staff overreliance on computer systems. Reducing the incidence of pretreatment events is of particular importance because these were more likely to occur several times before detection and were associated with larger dosimetric impact. Further improvements in quality assurance systems and reporting are imperative, given the advent of electronic charting, increasing reliance on computer systems, and the potentially severe consequences that can arise from mistakes involving complex intensity-modulated or image-guided treatments. Copyright © 2012 Elsevier Inc. All rights reserved.
Keywords: retrospective studies; intensity modulated radiation therapy; methodology; classification; statistics; oncology; retrospective study; algorithms; time; time factors; risk assessment; health care quality; standard; radiology; algorithm; radiation oncology; radiotherapy, intensity-modulated; total quality management; quality assurance, health care; patient safety; radiotherapy planning, computer-assisted; computer assisted radiotherapy; factual database; databases, factual; medical error; medical errors; quality improvement; technology, radiologic
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 84
Issue: 4
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2012-11-15
Start Page: 925
End Page: 931
Language: English
PUBMED: 22494585
PROVIDER: scopus
Notes: --- - "Export Date: 1 February 2013" - "Source: Scopus"