Combining Safety Checks May Reduce Radiotherapy Errors

When combined, 6 common, recognized radiotherapy safety checks cut potential patient-harming errors by 90%, according to a new study led by Johns Hopkins researchers. 

Working with Washington University in St. Louis, researchers systematically evaluated more than 12 well-known safety checks in about 4000 “near-miss” events at the 2 institutions. They found that the quality assurance measures were more effective in combination than separately. “While clinicians in this field may be familiar with these quality assurance procedures, they may not have appreciated how effective they are in combination,” stated Eric Ford, PhD, DABR, assistant professor of radiation oncology and molecular radiation sciences at Johns Hopkins, in a press release (Aug 3, 2011).

 

The key quality measures included:

• An electronic portal imaging device (EPID), which is built into many radiotherapy-delivery machines and can provide a real-time X-ray-like image of the radiation coming through a patient.
• A checklist of relatively low-tech measures, such as reviews of patient charts before treatment by both physicians and radiation-physicists, who calculate the right dose of radiation.
• Film-based radiation-dose measurements as an alternative to EPID.
• A mandatory timeout by the radiation therapist before radiation is turned on to double-check that the written treatment plan and doses match what’s on the radiation delivery machines.