A rigorous program of continuous equipment testing, treatment monitoring, and independent review ensures the safety of our patients. Our department is accredited by the American College of Radiology (ACR), which provides a third-party, impartial peer review and evaluation of patient care. Before granting accreditation, the ACR assesses quality and safety of patient care, documentation of policies and procedures, equipment maintenance, and treatment planning records.
Radiation oncologists, technicians, physicists, and equipment specialists perform safety checks at every step of the treatment process — from the day radiotherapy machines are installed to the planning and delivery of each treatment.
These checks ensure radiation therapy treatments are appropriate and customized for each patient. They provide an opportunity to review every patient's treatment plan and make modifications as necessary. Plus, they create an environment where safety — and its improvement — is an intrinsic part of treatment.
The linear accelerator (LINAC) machine that delivers radiation therapy to patients has redundancy systems to control and monitor radiation doses and direction. These systems shut off the LINAC if it is not performing to specifications.
All LINACs undergo an extensive set of quality assurance measurements to ensure the radiation therapy is delivered correctly and the system for planning radiotherapy treatments is fully in sync with each LINAC. This is followed by a schedule of daily, monthly, and annual tests to monitor LINAC performance. There is also a system of independent checks is in place to verify that the calculations used to program the LINAC and position of each patient is correct.
All new treatment plans are examined by clinical faculty at meetings known as chart rounds. During these meetings, physicians, treatment planners, physicists and radiation therapists perform peer reviews of treatment plans and patient charts. Additional quality checks are performed prior to the initiation of any treatment course.
All patients on treatment are monitored by physicians at regular intervals over the course of their therapy.
The accuracy of radiation is regularly verified prior to treatment with advanced images that are reviewed by attending physicians.
A non-punitive safety reporting system encourages any member of the department to report errors or near misses. All such reports are reviewed by the multidisciplinary Quality Improvement Committee. This committee suggests improvements in department processes and communicates with hospital safety committees as well as the Massachusetts Department of Public Health's Radiation Control Program.
Staff conduct the following safety checks at every phase of machinery operation and treatment planning and delivery.
We maintain a quality assurance system for reporting adverse events and near misses that meets and exceeds national standards. All such events are reviewed by the department’s Quality Improvement Committee and are reported to the hospital safety committees and state regulators when appropriate. Such incidents may trigger a Root Cause Analysis, in which specialists investigate the causes of the problem and formulate plans to prevent it in the future. Our safety record is well documented and very good, but we constantly strive to improve.
The Department of Public Health’s Radiation Control Program requires reporting of mistreatments that meet a variety of criteria. These include treating the incorrect patient, the incorrect site, using the incorrect modality, or treatments that deviate from the specifications of the planned treatment. The criteria for these "misadministrations" are detailed in the program’s regulation CMR 120.435.
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