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Highlights COVID-19 impact on safety in radiation oncology. Failure modes and effects analysis applied to pandemic response. Examination of how infection control measures impact radiotherapy workflow. Multi-institution study of COVID-19-related practices in radiation oncology departments.

Incident learning systems can be used to assess the most common points of error origination and detection in radiation oncology. This can help tailor safety improvement efforts and target the highest impact portions of the workflow. The most severe near-miss events tend to originate during simulation, with the most severe near-miss events detected at the time of patient treatment. Safety barriers can be improved to allow earlier detection of near-miss events.