ESTRO 36 Abstract Book

S559 ESTRO 36 2017 _______________________________________________________________________________________________

PO-1021 An electronically configurable checklist program for quality control of RT treatment planning K.H. Grosser 1 , A.C. Schulte 1 , W. Harms 1 1 St. Claraspital, Radiooncology, Basel, Switzerland Purpose or Objective To asses efficacy of an adaptive checklist program to facilitate plan review for physicists. Material and Methods Pre-treatment plan review is fundamentally important to patient safety and treatment plan quality. A critical control point in this process is the ‘Planning Approval‘ process. To reduce the error rate we developed an adaptive electronical planning approval checklist as part of our quality assurance. We applied this program to more than 600 treatment plans produced with the Eclipse treatment planning system (VARIAN). Because we wanted to optimize the checklist continuously the program was set up to be adaptive with respect to the plan type and to allow the addition of new checklist items. All evaluated cases were documented in a database. The incidence rates of errors and their types are reported. Results The checklist program was introduced into clinical routine in October 2012 and was used in this version until the end of 2015. In total 638 plans were checked. With the help of this checklist program 303 errors in 190 treatment planes were detected. Most errors were classified as minor errors (i.e. incorrect target volume nomenclature). However, 29 dose-related errors have also been found. 13 new checklist items have been gradually added to the existing checklist to account for newly detected error possibilities. The average time to complete the checklist was approximately 3 minutes. The compliance rate was very high. As expected, the acceptance of the “Do-Confirm” strategy was higher than for the “Read-Do” practice. Conclusion A planning approval checklist is a valuable tool to reduce the error rate of treatment plan validation to almost zero. An automated or semi-automated checklist tool with direct access to the database of the treatment planning system would be desirable. PO-1022 Implementation of a paperless workflow in radiotherapy; Reducing transcription O. Shoffren 1 , Y. Tsang 1 , J. Kudhail 1 Purpose or Objective It is well recognised that due to the complexities of the radiotherapy pathway transcription errors are common. As such robust processes are in place throughout the treatment pathway to ensure checking processes are fit for purpose. With the importance on using source data to eliminate this potential for transcription errors to arise, our centre has adopted a paperless workflow allowing access to source data ; from referral to the last fraction of radiotherapy. The aim of the study was to evaluate the effectiveness of the new workflow in terms of reducing errors. Material and Methods Since April 2016, a paperless workflow has been introduced for each area of the pathway including; referral, data capture at CT, planning information and treatment information up to the last fraction. A focus group was formed to investigate the options available for recording the required information at all stages. These included using an electronic referral and booking form, dynamic documents for recording treatment setup details, electronic journals for recording actions and histories throughout the treatment and toxicity scoring. All checks required on before, during and after treatments were 1 Mount Vernon Cancer Centre, Radiotherapy Department, borehamwood, United Kingdom

assigned as tasks or checklists and these were made into a standardised automated protocol.All errors at our centre are recorded electronically on a centralised incidence reporting system. The numbers of error occurrences that happened 3 months before and after the introduction of the process were analysed. Results In total, there were 51 and 49 radiotherapy related incidents recorded before and after the introduction of the paperless workflow respectively. The number of incidents related to transcription errors decreased from 29% (15/51) to 16% (8/49) since the paperless change. It’s noted that there was a small rise in reported incidences in other areas of the pathway due to a change in work It’s suggested the number of transcription errors was minimised through the adoption of the paperless workflow. It’s also proved to be beneficial to have a centralised electronic incident reporting system to monitor and review incidents in a radiotherapy department, in order to streamline and optimise existing patient pathways. PO-1023 Reducing waiting room times - A 5 year review of an in-house KPI tool A. Wallis 1 , D. Moretti 1 1 Liverpool Hospital, Radiation Oncology, Liverpool, Australia Purpose or Objective Patient waiting times has a significant impact in a patient’s overall satisfaction of their healthcare experience (1). The main contributors to patient waiting times are inadequate appointment duration, staff experience level, patient late arrival and machine breakdowns (1). Literature on radiation oncology productivity is dominated by variation and validation of the basic treatment equivalent (BTE) model (2). However, the technological advancements in imaging and treatment modalities such as intensity modulated radiation therapy (IMRT), image guided radiotherapy (IGRT), volumetric RT (VMAT) and Tomotherapy have changed the landscape of RT and its productivity measures (4). In 2011, the management team at Liverpool and Macarthur Cancer Therapy Centres (LMCTC) introduced an in-house key performance indicator (KPI) tool to measure the performance of the treatment machines. The catalyst for the design and implementation of the tool was the introduction of the New South Wales (NSW) Performance Measures report of 2010 (3). The main objective of the tool was to capture each individual patient's appointment time to ensure adequate and individualised patient appointment scheduling. It was hypothesised that the introduction of this tool would reduce the waiting room time for patients. Material and Methods In 2010, Mosaiq 2.0X was installed in LMCTC. This version allowed the extraction of time stamps in a reporting tool (Crystal reports version 11). Standardisation of the treatment processes improved the robustness of patient data and allowed accurate extraction of time stamps in Mosaiq. This data were then imported into Microsoft Excel on a weekly basis for visual display of the KPIs. The tool was launched in October of 2010 for a trial period of two months and has been in use in the department since its introduction. Results During the period of October to December 2010, the department recorded that 56% of patients were treated on time. Since the tool was introduced and actioned in 2011, the department has recorded an average of 71.2% (range 69-76%) of patients treated on time. These results are encouraging considering the number of attendances to the department has increased over the 5 year period (Fig 1). procedure. Conclusion