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• W2064926488 abstract "Purpose/Objective(s)Learning from radiation incidents plays a vital role in improving the safety of radiation therapy treatments. In this work, we developed a procedure to improve the initial clinical chart review process by identifying safety-critical information to be highlighted in treatment plan report documentation through the analysis of an international error reporting database.Materials/MethodsThe Radiation Oncology Safety Information System (ROSIS) database is an international voluntary reporting database of incidents and near misses in radiation therapy. The database was queried for events involving external beam treatments that were reported from 2003 to present. Events that could occur prior to an initial chart review, such as at the time of planning or data transfer to the record and verify system, were identified. Errors originating at the treatment machine at the time of delivery would have occurred after an initial chart review and were therefore excluded from analysis. Safety-critical plan parameters that would appear in a treatment plan report were then identified from these events. Errors related to parameters that would not appear on a treatment plan report, for example erroneous marking of the patient's skin, were excluded.ResultsThree hundred sixty-four events were identified as originating prior to treatment delivery and relating to erroneous parameters that can be displayed in a treatment plan report. Seventy-six events were involved with beam setup and parameter selection during planning or simulation. Common events included erroneous manual fabrication of cerroband blocks, bolus, or compensators (n = 23); mistakes with field size or aperture shape selection (27); isocenter placement (10); and couch, collimator, or gantry angle selection (10). Furthermore, 77 events were involved with dose or monitor unit calculation. Common calculation errors included the incorrect use of transmission factors (20); calculation factors from incorrect beam energy, field size, distance, or treatment machine (21); treatment depth (14); and dose prescription or normalization (12). Last, erroneous planning parameters in the record and verify system or chart documents were identified in 184 events. Common parameters included field size or aperture shape (48); couch, collimator, or gantry settings (30); isocenter setup instructions (25); field monitor units (15), wedges (12); and verification DRR images (11).ConclusionsAn international incident and near miss reporting database was analyzed to identify erroneous planning parameters that can appear in treatment plan report documentation. These parameters can subsequently be highlighted in a customized treatment plan report for the purpose of improving the chart review process and enhancing patient safety. Purpose/Objective(s)Learning from radiation incidents plays a vital role in improving the safety of radiation therapy treatments. In this work, we developed a procedure to improve the initial clinical chart review process by identifying safety-critical information to be highlighted in treatment plan report documentation through the analysis of an international error reporting database. Learning from radiation incidents plays a vital role in improving the safety of radiation therapy treatments. In this work, we developed a procedure to improve the initial clinical chart review process by identifying safety-critical information to be highlighted in treatment plan report documentation through the analysis of an international error reporting database. Materials/MethodsThe Radiation Oncology Safety Information System (ROSIS) database is an international voluntary reporting database of incidents and near misses in radiation therapy. The database was queried for events involving external beam treatments that were reported from 2003 to present. Events that could occur prior to an initial chart review, such as at the time of planning or data transfer to the record and verify system, were identified. Errors originating at the treatment machine at the time of delivery would have occurred after an initial chart review and were therefore excluded from analysis. Safety-critical plan parameters that would appear in a treatment plan report were then identified from these events. Errors related to parameters that would not appear on a treatment plan report, for example erroneous marking of the patient's skin, were excluded. The Radiation Oncology Safety Information System (ROSIS) database is an international voluntary reporting database of incidents and near misses in radiation therapy. The database was queried for events involving external beam treatments that were reported from 2003 to present. Events that could occur prior to an initial chart review, such as at the time of planning or data transfer to the record and verify system, were identified. Errors originating at the treatment machine at the time of delivery would have occurred after an initial chart review and were therefore excluded from analysis. Safety-critical plan parameters that would appear in a treatment plan report were then identified from these events. Errors related to parameters that would not appear on a treatment plan report, for example erroneous marking of the patient's skin, were excluded. ResultsThree hundred sixty-four events were identified as originating prior to treatment delivery and relating to erroneous parameters that can be displayed in a treatment plan report. Seventy-six events were involved with beam setup and parameter selection during planning or simulation. Common events included erroneous manual fabrication of cerroband blocks, bolus, or compensators (n = 23); mistakes with field size or aperture shape selection (27); isocenter placement (10); and couch, collimator, or gantry angle selection (10). Furthermore, 77 events were involved with dose or monitor unit calculation. Common calculation errors included the incorrect use of transmission factors (20); calculation factors from incorrect beam energy, field size, distance, or treatment machine (21); treatment depth (14); and dose prescription or normalization (12). Last, erroneous planning parameters in the record and verify system or chart documents were identified in 184 events. Common parameters included field size or aperture shape (48); couch, collimator, or gantry settings (30); isocenter setup instructions (25); field monitor units (15), wedges (12); and verification DRR images (11). Three hundred sixty-four events were identified as originating prior to treatment delivery and relating to erroneous parameters that can be displayed in a treatment plan report. Seventy-six events were involved with beam setup and parameter selection during planning or simulation. Common events included erroneous manual fabrication of cerroband blocks, bolus, or compensators (n = 23); mistakes with field size or aperture shape selection (27); isocenter placement (10); and couch, collimator, or gantry angle selection (10). Furthermore, 77 events were involved with dose or monitor unit calculation. Common calculation errors included the incorrect use of transmission factors (20); calculation factors from incorrect beam energy, field size, distance, or treatment machine (21); treatment depth (14); and dose prescription or normalization (12). Last, erroneous planning parameters in the record and verify system or chart documents were identified in 184 events. Common parameters included field size or aperture shape (48); couch, collimator, or gantry settings (30); isocenter setup instructions (25); field monitor units (15), wedges (12); and verification DRR images (11). ConclusionsAn international incident and near miss reporting database was analyzed to identify erroneous planning parameters that can appear in treatment plan report documentation. These parameters can subsequently be highlighted in a customized treatment plan report for the purpose of improving the chart review process and enhancing patient safety. An international incident and near miss reporting database was analyzed to identify erroneous planning parameters that can appear in treatment plan report documentation. These parameters can subsequently be highlighted in a customized treatment plan report for the purpose of improving the chart review process and enhancing patient safety." @default.
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• W2064926488 date "2012-11-01" @default.
• W2064926488 modified "2023-09-27" @default.
• W2064926488 title "Analysis of an International Error Reporting Database to Enhance Patient Safety" @default.
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