Micro ElectroMechanical Systems' (MEMS) Quality Assurance Potential in the Assessment of Patient Motion During Radiation Therapy

Abstract

the need for process evaluation in the context of high profile accidents. A multidisciplinary team was assembled with representation from each major discipline. Stereotactic radiosurgery (SRS) was identified as an ideal treatment technique for the first FMEA evaluation, as it is a largely selfcontained process in our department and has the potential to produce high impact failure modes. Process mapping was completed using breakout sessions, and then compiled into a simple electronic format. Weekly sessions were used to complete the FMEA evaluation. Risk priority number (RPN) values > 100 or severity scores of 9 or 10 were considered high risk. The overall time commitment was also tracked. Results: We found that FMEA was feasible, though time-intensive, within our small community practice. The estimated person-hour equivalent for project completion was 258 hours. Key steps included: clear definition of project scope, motivated team recruitment, coordinated completion of FMEA task assignments, determination of appropriate process map detail level, and ensuring FMEA scoring consistency. Splitting the process map into individual assignments was a successful strategy for our group. The process map was designed to contain enough detail such that another radiation oncology team would be able to perform our procedures. The FMEA evaluation utilized weekly open sessions to provide facilitator support and optimize team member input. Continuous facilitator involvement helped maintain consistent scoring. The final SRS process map contained 15 major process steps and 183 sub-process steps. Conclusion: This study provides important details on the steps we took to complete our first FMEA, providing guidance for community practices seeking to incorporate this process into their quality assurance (QA) program. Based on our data and experiences, we estimate that 6-12 months will be required for a clinic to complete their first FMEA, with subsequent analyses likely progressing more quickly once a group has developed familiarity with the technique. Determining the feasibility of implementing complex QA processes into different practice settings will take on increasing significance as the field transitions into the new AAPM TG-100 QA paradigm.