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Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Technology

机译：在放射治疗的安全性和质量管理中实施事件学习：新建立的具有先进技术的计划的主要经验

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摘要

Objective. To explore the implementation of incident learning for quality management of radiotherapy in a new established radiotherapy program. Materials and Methods. With reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically established for reporting, investigating, and learning of individual incidents. The incidents that occurred in external beam radiotherapy from February, 2012, to February, 2014, were reported. Results. A total of 28 near misses and 5 incidents were reported. Among them, 5 originated in imaging for planning, 25 in planning, and 1 in plan transfer, commissioning, and delivery, respectively. One near miss/incident was classified as wrong patient, 7 wrong sites, 6 wrong laterality, and 5 wrong dose. Five reported incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, and inadequate training contributed to 19, 15, and 12 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4. Conclusion. Effective implementation of incident learning can reduce the occurrence of near misses/incidents and enhance the culture of safety.
机译：目的。在新建立的放射治疗计划中探索事件学习对放射治疗质量管理的实施。材料和方法。根据美国医学物理学会的共识建议，专门建立了事件学习系统，用于报告，调查和学习单个事件。据报道，2012年2月至2014年2月发生在外部束放射治疗中的事件。结果。总共报告了28起未命中事件和5起事件。其中，有5项来自计划的成像，有25项来自计划，而有1项来自计划转移，调试和交付。一名接近未遂/事件被分类为错误的患者，7个错误的位置，6个错误的侧向和5个错误的剂量。已报告的五起事件均被归类为剂量严重度的1/2级，1次被归为0级，其他4次被归为医疗严重性1级。对于原因/归因，疏忽，未遵循政策以及培训不足分别导致19、15和12个未命中/事件。每100名患者的平均发病率为0.4。结论。有效实施事件学习可以减少附近未遂/事件的发生，并增强安全文化。

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