Radiation therapy facility risk analysis in Brazil with SEVRRA software

Abstract

Risk assessment deals with processes, accident-initiating events, barriers and risk ratings to unveil the fragility and weakness of some processes; within this study, specifically related to radiation therapy facilities. Barriers are technical or organizational safety measures put in place to avoid, prevent, detect, control, reduce or mitigate the consequences of an accident once an initiating event has occurred. In this work, radiological risk analysis was performed for a set of 20 Brazilian radiotherapy facilities making use of the freeware sevrra risk-management software. The objective of this study was to define parameters that could be useful in creating an overall risk profile. This profile would be helpful for establishing priorities for decision making and support a risk-informed regulatory process. The most relevant missing barriers in facilities were identified according to three parameters: the 'importance index', 'impacted facilities index' and the 'barrier-effectiveness index'. Barriers such as 'in vivo dosimetry in the first treatment session', 'weekly in vivo dosimetry to detect errors in the dose delivering process', 'annual external audit for the control of reference dose rate' and 'independent verification of calibration by various medical physicists with a different dosimetry equipment' were found to be the most effective in reducing the risk level of the facilities. The present investigation reinforces the need to strengthen the mechanisms that guarantee the effectiveness of such barriers in radiation therapy procedures.

Applicability of ‘Toolkit for Safety Assessment’ tool to interventional radiology using probabilistic risk assessment techniques

“…FRs are measures for avoiding or preventing an initiating event [24,25] that have been demonstrated as efficient in reducing its occurrence. Examples include training IOEs, workload moderation, regular preventive maintenance in equipment, and radiation protection measures.…”

“…DBs detect initiating events and anticipate consequences. An example is reviewing procedure planning [21,24,25].…”

Fit-for-purpose: solutions to real issues–the Bernard Wheatley award for 2018

“…Software also features in Joana et al (2018), but in this case a simple procedural programme not a complex mathematical analysis. This paper describes how the SEVRRA software package, which is being used to perform risk analyses relating to radiation therapy in approximately 100 facilities in Brazil, was used to evaluate risks at 20 facilities that collaborated in the study.…”