Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study

Adleman, Jenna; Gillan, Caitlin; Caissie, Amanda; Davis, Carol-Anne; Liszewski, Brian; McNiven, Andrea; Giuliani, Meredith

doi:10.1016/j.ijrobp.2016.11.031

Cited by 13 publications

(6 citation statements)

References 28 publications

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“…As only highly dangerous incidents are reported here, the number of incidence actually occurring during daily treatment might be much higher [12]. Risk management now offers the opportunity to anticipate possible failures, systematically learn from incidents, and implement measures to reduce risks which contributes to a safe therapy environment and is recommended by several authorities [8,[13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Risk management patterns in radiation oncology—results of a national survey within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project

Baehr

Hummel²,

Gauer

et al. 2022

Strahlenther Onkol

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Purpose Risk management (RM) is a key component of patient safety in radiation oncology (RO). We investigated current approaches on RM in German RO within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project. Aim was not only to evaluate a status quo of RM purposes but furthermore to discover challenges for sustainable RM that should be addressed in future research and recommendations. Methods An online survey was conducted from June to August 2021, consisting of 18 items on prospective and reactive RM, protagonists of RM, and self-assessment concerning RM. The survey was designed using LimeSurvey and invitations were sent by e‑mail. Answers were requested once per institution. Results In all, 48 completed questionnaires from university hospitals, general and non-academic hospitals, and private practices were received and considered for evaluation. Prospective and reactive RM was commonly conducted within interprofessional teams; 88% of all institutions performed prospective risk analyses. Most institutions (71%) reported incidents or near-events using multiple reporting systems. Results were presented to the team in 71% for prospective analyses and 85% for analyses of incidents. Risk conferences take place in 46% of institutions. 42% nominated a manager/committee for RM. Knowledge concerning RM was mostly rated “satisfying” (44%). However, 65% of all institutions require more information about RM by professional societies. Conclusion Our results revealed heterogeneous patterns of RM in RO departments, although most departments adhered to common recommendations. Identified mismatches between recommendations and implementation of RM provide baseline data for future research and support definition of teaching content.

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Section: Introductionmentioning

confidence: 99%

Risk management patterns in radiation oncology—results of a national survey within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project

Baehr

Hummel²,

Gauer

et al. 2022

Strahlenther Onkol

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“…A recent international Delphi study recommended patient safety/QI competencies for RO residents that require proficiency in both procedural and non-technical areas, such as how to engage patients to champion the safety and quality of their treatment [ 12 ]. RO educators’ scope of practice including non-technical aspects of patient safety/QI compared to MP PDs may explain why they are more likely to use a M&M facilitator guide and implement M&M.…”

Section: Discussionmentioning

confidence: 99%

“…These resources are becoming increasingly available. They include a detailed list of patient safety/QI competencies for RO residents [ 12 ], a framework for didactics [ 13 ] and web-based modules (i. treatsafely.org , IAEA e-Learning course ( www.iaea.org/resources/rpop ), Institute for Healthcare Improvement ( ihi.org ), and a safety culture education program [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Radiation oncology resident training in patient safety and quality improvement: a national survey of residency program directors

et al. 2018

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BackgroundPhysicians and physicists are expected to contribute to patient safety and quality improvement (QI) in Radiation Oncology (RO), but prior studies suggest that training for this may be inadequate. RO and medical physics (MP) program directors (PDs) were surveyed to better understand the current patient safety/QI training in their residency programs.MethodsPDs were surveyed via email in January 2017. Survey questions inquired about current training, curriculum elements, and barriers to development and/or improvement of safety and QI training.ResultsEighty-nine RO PDs and 84 MP PDs were surveyed, and 21 RO PDs (28%) and 31 MP PDs (37%) responded. Both RO and MP PDs had favorable opinions of current safety and QI training, and used a range of resources for program development, especially safety and QI publications. Various curriculum elements were reported. Curriculum elements used by RO and MP PDs were similar, except RO were more likely than MP PDs to implement morbidity and mortality (M&M) conference (72% vs. 45%, p < 0.05). RO and MP PDs similarly cited various barriers, but RO PDs were more likely to cite lack of experience than MP PDs (40% vs. 16%, p < 0.05). PDs responded similarly independent of whether they reported using a departmental incident learning system (ILS) or not.ConclusionsPDs view patient safety/QI as an important part of resident education. Most PDs agreed that residents are adequately exposed to patient safety/QI and prepared to meet the patient safety/QI expectations of clinical practice. This conflicts with other independent studies that indicate a majority of residents feel their patient safety/QI training is inadequate and lacks formal exposure to QI tools.Electronic supplementary materialThe online version of this article (10.1186/s13014-018-1128-5) contains supplementary material, which is available to authorized users.

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“…Quality improvement and patient safety programmes in radiotherapy units have mostly focused on the accuracy of treatment planning and the avoidance of errors [16][17][18][19] ; however, there is a paucity of studies focusing on the rapid response to a sudden deterioration in a patient's condition in the treatment room. Although radiotherapy itself is a low-invasive procedure, patients receiving radiotherapy are often old with multiple comorbidities and constitute a vulnerable population.…”

Section: Lessons and Limitationsmentioning

confidence: 99%

Implementation of a rapid response system at an isolated radiotherapy facility through simulation training

et al. 2022

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A rapid response system is required in a radiotherapy department for patients experiencing a critical event when access to an emergency department is poor due to geographic location and the patient is immobilised with a fixation device. We, therefore, rebuilt the response system and tested it through onsite simulations. A multidisciplinary core group was created and onsite simulations were conducted using a Plan-Do-Study-Act cycle. We identified the important characteristics of our facility, including its distance from the emergency department; the presence of many staff with little direct contact with patients; the treatment room environment and patient fixation with radiotherapy equipment. We also examined processes in each phase of the emergency response: detecting an emergency, calling the medical emergency team (MET), MET transportation to the site and on-site response and patient transportation to the emergency department. The protocol was modified, and equipment was updated. On-site simulations were held with and without explanation of the protocol and training scenario in advance. The time for the MET to arrive at the site during a 2017 simulation prior to the present project was 7 min, whereas the time to arrive after the first simulation session was shortened to 5 min and was then shortened further to 4 min in the second session, despite no prior explanation of the situation. A multidisciplinary project for emergency response with on-site simulations was conducted at an isolated radiation facility. A carefully planned emergency response is important not only in heavy ion therapy facilities but also in other departments and facilities that do not have easy access to hospital emergency departments.

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Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study

Cited by 13 publications

References 28 publications

Risk management patterns in radiation oncology—results of a national survey within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project

Risk management patterns in radiation oncology—results of a national survey within the framework of the Patient Safety in German Radiation Oncology (PaSaGeRO) project

Radiation oncology resident training in patient safety and quality improvement: a national survey of residency program directors

Implementation of a rapid response system at an isolated radiotherapy facility through simulation training

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