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• W2896843242 abstract "To demonstrate how safe treatment delivery is improved utilizing high quality procedural standardization in spite of inherent obstacles within our large teaching institution’s radiation oncology department. Diverse treatment vendors, inconsistent indexing and setup instructions, and varying treatment field table tolerances can lead to increased overrides and therapist override fatigue, resulting in radiation incidents. Over the past 5 years, our institution has applied several measures to reduce the amount of incidents, with geographic misses being the most crucial. Our department had utilized three separate vendors for treatment machines, but has recently replaced a majority of machines to one vendor specifically. This has allowed us to standardize our table indexing and setup instructions for daily treatment, as well as automatically move the table to isocenter as a result of new technology. New, stringent, table treatment tolerances have been set into place based specifically on treatment site and frequency of imaging. A dosimetry plan consistency check, which is an in-house built program to ensure treatment beams will properly deliver in the radiation treatment plan, has allowed us to better predict the planned vertical value relative to table sag, among other things. Utilizing a daily overrides email report, an examination of overrides for 2017 in particular shows a significant downward trend.Abstract TU_18_3076; Table 1Overrides 2017MarchAprilMayJuneJulyAugustSeptemberOctoberNovemberLinac1605749614757512016Linac21271073024463538223Linac3796646204332251217Linac4447038395344534514Radiosurgery21065877783559431630Radiosurgery10626413421381018Total41636426626325824824812598 Open table in a new tab Much of the historical data has shown many incidents to be related to overrides, several different treatment machine vendors and inconsistent table tolerances. Over the studied 5 year span, a decrease of nearly 80% in geographic miss incidents relative to overrides and setup has been observed. Analysis of implemented changes with regards to procedural standardization and concise treatment table tolerances has shown a sharp decrease of approximately 75% in overrides over the past year in particular from the span of March through November. Procedural standardization is crucial to the delivery of safe high quality radiation treatment. Particular attention to the frequency and magnitude of overrides and table parameters prior to treatment leads to an increased awareness of accurate treatment position. As a result, we believe patient safety is improved, and related incidents are prevented." @default.
• W2896843242 created "2018-10-26" @default.
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• W2896843242 date "2018-11-01" @default.
• W2896843242 modified "2023-10-18" @default.
• W2896843242 title "Radiation Treatment Incidents Are Significantly Reduced Using Modified Treatment Table Parameters and Daily Overrides Report" @default.
• W2896843242 doi "https://doi.org/10.1016/j.ijrobp.2018.07.1320" @default.
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