Abstract Book

ESTRO 37

S619

A multistep development process was deployed, including the principles of Quality Function Deployment (QFP). The consecutive steps involved developing a process comparable to a systematic review (Fig. 1) and forming a Multi-Profession Team (MPT) of which the quorate members included the radiotherapy MDT: Radiation Therapists, Oncologists, Physicists, Service Leads and Clinical Librarians. The MDT provided the Clinical Librarians with search terms. Full papers were then selected from lists of abstracts by the MPT providing new evidence for the live update. The MPT convened for 3 hours for the live update concluding with a clinical protocol approved for radiotherapy practice using Q- Pulse® quality management system. The process of the live update was initially evaluated for the percentage difference to the clinical protocol in the following areas: dose/fractionation, outlining, planning, image guidance and treatment delivery compared to the previous 2 years. Satisfaction of the live update was scored on a 5 point Likert scale among the MPT (1 Very dissatisfied; 5 Very satisfied). Questions included: how satisfied were you with the process/ end result? Results A process was developed for the live update based on QFP which was planned to convene every 2.5 years per clinical radiotherapy protocol . Since 2014 twelve clinical radiotherapy protocols have been through the live update process, with one having been through a second time. The live update resulted in 80% of differences to the clinical protocol compared to the previous two years before the process. Among 11 respondents, a mode of 5 was scored for how satisfied the MPT were with the process and end result (Fig. 2). Some free text feedback included: “A novel process which really improved MDT working” and “Having the Clinical Librarian involved is impressive and ensures evidence based practice” with suggestions including administrative support for transcribing at the live update.

date clinical practice based on the latest evidence contributing to improved patient outcomes.

PO-1100 Risks related to replacement of technical platform: shared experience of 2 radiotherapy centers. S. Cucchiaro 1 , M. Delgaudine 2 , A. Batamuriza-Almasi 3 , P. Coucke 1 1 C.H.U. - Sart Tilman, Radiotherapy department, Liège, Belgium 2 C.H.U. - Sart Tilman, STA Quality department, Liège, Belgium 3 CH-EpiCURA, Radiotherapy department, Baudour, Belgium Purpose or Objective Replacing a linear accelerator in a Radiation Therapy (RT) department is a complex operation. 2 RT centers are currently undergoing this change. Center 1 is moving his RT department to a new technical platform and center 2 is replacing an accelerator. To guarantee the quality and performance of these projects, one might prospectively analyze problems that can occur through risk management methods such as Failure Modes Effects and Criticality Analysis (FMECA). Material and Methods The 2 projects have been defined and structured. A risk analysis according to FMECA process was carried out. This analysis is divided into 5 steps. Step 1: break down the 2 projects in into sever al phases. Step 2: identify failure modes, their effects, and possible causes. Step 3: establish a risk assessment scale and classify the risks. The evaluation was based on 3 criteria: Severity (S), frequency of Occurrence (O) and probability of Detection (D). Criticality Index (CI = S x O x D) was calculated for each identified risk. Step 4: identify appropriate preventive actions and set up action plans. Step 5: follow actions decided and indicators deployed. Risk mapping obtained facilitates identification of priority actions to be carried out and to follow and is represented in tabular form. Results For each project, we obtained a detailed scoreboard with the different phases and with risks assessed. Application of FMECA highlighted different vulnerable phases of each project. Critical phases identified for center 2 project include the shutdown of old accelerator (delayed take-over as only one accelerator in operation on 2) or staff training on the new machine. Vulnerable phases identified in center 1 project are, among others, the maintenance of treatments on the 2 sites: there must be sufficient staff to ensure safe care on the old and new technical platform. The start of medical consultations is a critical moment too as these consultations will no longer be on the same level as the technical platform. Staff training on new equipment is also a critical phase for the move project as well as for the accelerator replacement project. Various preventive actions have taken place out of these 2 risk analyzes: staff recruitment, new medical consultation plan, development of a training program and adaptation of treatment schedules. The figure 1 shows an extract of FMECA scoreboard obtained for center 1 project. Sharing of experience between the 2 RT departments on

Conclusion The novel approach of the live update has been successful in providing a lean process ensuring that the latest evidence reaches clinical radiotherapy practice. An innovative collaboration incorporated Clinical Librarians with the radiotherapy MDT for ensuring an efficient, methodical approach and improved team working. The lean process of the real-time live update resulted in a small investment of time from the MPT ensuring up-to-