The Need for Physician Leadership in Creating a Culture of Safety

Advances in radiotherapy

“…16 The risk of death directly caused by radiotherapy errors is estimated at two per million courses in the UK and 15 per million courses in an international systematic review. For comparison, the risk of a crash on a commercial air flight is four per million departures.…”

A patient safety education program in a medical physics residency

“…In one of these, a national survey of physician and physics residents, a majority of respondents reported that formal teaching of patient safety was inadequate in their program 10. The need for a structured learning program is also motivated by the requirements of residency accrediting bodies,1, 3 the recent trends around reimbursement models that include quality reporting components (e.g., MACRA in the USA), and the need for physicians and physicists to serve as leaders in this arena 5, 6. Training is listed as a key component in essentially all reports providing recommendations around patient safety 8.…”

“…It is also reflective of trends in reimbursement models (e.g., MACRA in the US) that explicitly call for the inclusion of quality metrics 4. Rigorous education in quality and safety is also needed if physicians and physicists are expected to be leaders in this arena, as has been suggested 5, 6. Additionally, the recent AAPM Task Group‐100 report advocates that safety and quality “need to be incorporated in training programs for all radiation oncology disciplines.”7 It is also called for in other reports providing recommendations around patient safety 8…”

Rechtliche Grundlagen für den Umgang mit sicherheitsrelevanten Ereignissen in der Strahlentherapie

“…Trotzdem ist es möglich, dass durch Fehler bei der Planung oder Durchführung für einzelne Patienten oder Patientengruppen das Zielgebiet inadäquat versorgt oder die Risikostrukturen übermäßig geschädigt werden können. Hierfür gibt es unterschiedlichste Gründe: Fehlerhafte Planungs-oder Therapiegeräte, unzureichende Wartung oder Kontrollen, mangelnde Aus-oder Weiterbildung des Personals oder eine zufällige Verkettung von im Einzelnen eher unbedeutenden, in ihrer Gesamtwirkung aber nicht vernachlässigbaren Abweichungen von vorgeschriebenen Verfahrensweisen [23,29,30]. Die Dokumentation eines solchen Ereignisses, Reaktionen auf die direkten Folgen, die Analyse der Fehlerursachen und Maßnahmen zu ihrer Beseitigung sind zuerst Aufgabe des abteilungsinternen Qualitätsmanagementsys-tems.…”