Towards Safer Radiotherapy

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Appendix 3.1. Radiotherapy pathway coding NB: This coding system was developed and tested with the help of members of the London Radiotherapy Quality Assurance Network. All coding systems are dynamic as systems change and new procedures invented therefore further codes will be have to be added as required. Process code Activity code 0 Scientific infrastructure 0a 0b 0c 0d Implementation of national and international codes of practice for radiation dosimetry Development of dosimetry algorithms for local application Development of treatment planning algorithms for local application Other Equipment-specific activities 61 1 Room design 1a 1b 1c 1d 1e Patient safety Staff and public safety Environmental controls Access control Other 2 New equipment 2a 2b 2c 2d 2e 2f 2g 2h 2i Installation Manufacturer’s tests Acceptance tests Critical examination under IRR99 Customisation and configuration of equipment Commissioning Data recording Preparation of data files for planning computers Other 3 Routine machine QA 3a Daily consistency checks – geometric parameters Towards Safer Radiotherapy
62 3b 3c 3d 3e 3f 3g 3h 3i 3j 3k 3l Daily consistency checks – dosimetric calibration Daily consistency checks – safety (IRR compliance) Daily verification of accuracy of data transfer between TPS, R&V system and treatment equipment Planned QA programme checks – geometric parameters Planned QA programme checks – dosimetric calibration Planned QA programme checks – safety (IRR compliance) Planned QA programme checks – image quality parameters (including CT, MR, portal, cone-beam, film processor) Regular preventative maintenance and repair programme Handover of radiotherapy equipment after planned QA and maintenance Routine radiation safety checks Other Patient-specific activities 4 Referral for treatment 4a 4b 4c 4d 4e 4f 4g 4h 4i 4j 4i Identification of patient Verification of diagnosis/extent/stage Choice of dose Choice of modality Choice of energy Choice of fractionation Choice of start date Consideration of patient condition/co-morbidities Choice of other interventions and their sequencing Consent process Other 5 Communication of intent 5a 5b 5c 5d Completion of request for treatment (paper/electronic) Recording of patient ID Completion of required demographics Completion of tumour-specific information Towards Safer Radiotherapy
Page 1 and 2:
IPEM Patient Safety Division The Ro
Page 3 and 4:
Foreword In my Annual Report on the
Page 5 and 6:
• This report contains detailed r
Page 7 and 8:
Chapter 2: Nature and frequency of
Page 9 and 10: technology tends to impair individu
Page 11 and 12: Table 2.1. Examples of radiation in
Page 13 and 14: 2.3.3 There was an average of 30 in
Page 15 and 16: Table 2.5. Errors with > 10 Gy than
Page 17 and 18: Chapter 3: Defining and classifying
Page 19 and 20: Near miss Other non-conformance A p
Page 21 and 22: 22 Table 3.1. Examples of classific
Page 23 and 24: Chapter 4: Prerequisites for safe d
Page 25 and 26: • The multidisciplinary team of p
Page 27 and 28: Recommendation All procedures shoul
Page 29 and 30: The audit process should ideally:
Page 31 and 32: tendering process in which the radi
Page 33 and 34: In addition to these scientific and
Page 35 and 36: Recommendation The precise details
Page 37 and 38: 5.6 Verification and checks of trea
Page 39 and 40: known discrepancies between clinici
Page 41 and 42: However, at the present time and in
Page 43 and 44: Staff should be provided with some
Page 45 and 46: Recommendation Each radiotherapy ce
Page 47 and 48: Chapter 6: Learning from errors Tho
Page 49 and 50: 6.2.1.b Voluntary reporting systems
Page 51 and 52: To avoid incorrect speculation and
Page 53 and 54: 7.1.4 Some errors may require a ret
Page 55 and 56: • Externally: Patients should use
Page 57 and 58: Summary of recommendations Departme
Page 59: 28. Commissioning of radiotherapy e
Page 63 and 64: 9 Mould room/workshop activities 64
Page 65 and 66: 13 Treatment unit process 66 13a 13
Page 67 and 68: 16f 16g Communication of follow-up
Page 69 and 70: Appendix 6.1. Care delivery problem
Page 71 and 72: 15. Girinsky T, van der Maazen R, S
Page 73 and 74: 52. Society and College of Radiogra
Page 75 and 76: 88. Appleyard R, Ball K, Hughes FE
Page 77 and 78: Glossary of terms 78 Anthropomorphi
Page 79 and 80: 80 In vivo dosimetry Isocentric Iso
Page 81 and 82: Abbreviations 82 BIR BSI CNS CPD CT
Page 83 and 84: Membership of Working Party Ms Geri
Page 85: The Royal College of Radiologists 3
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