Quality and safety in radiotherapy PDF
Preview Quality and safety in radiotherapy
Quality and Safety in Radiotherapy IMAGING IN MEDICAL DIAGNOSIS AND THERAPY William R. Hendee, Series Editor Quality and Safety in Radiotherapy Todd Pawlicki, Peter B. Dunscombe, Arno J. Mundt, and Pierre Scalliet, Editors ISBN: 978-1-4398-0436-0 Forthcoming titles in the series Image-Guided Radiation Therapy Informatics in Medical Imaging Daniel J. Bourland, Editor George C. Kagadis and Steve G. Langer, Editors ISBN: 978-1-4398-0273-1 ISBN: 978-1-4398-3124-3 Adaptive Radiation Therapy Stereotactic Radiosurgery and Radiotherapy Allen X. Li, Editor Stanley H. Benedict, Brian D. Kavanagh, and ISBN: 978-1-4398-1634-9 David J. Schlesinger, Editors ISBN: 978-1-4398-4197-6 Informatics in Radiation Oncology Bruce H. Curran and George Starkschall, Editors Cone Beam Computed Tomography ISBN: 978-1-4398-2582-2 Chris C. Shaw, Editor ISBN: 978-1-4398-4626-1 Adaptive Motion Compensation in Radiotherapy Martin Murphy, Editor Quantitative Magnetic Resonance Imaging in Cancer ISBN: 978-1-4398-2193-0 Thomas Yankeelov, Ronald R. Price, and David R. Pickens, Editors ISBN: 978-1-4398-2057-5 Image Processing in Radiation Therapy Kristy Kay Brock, Editor ISBN: 978-1-4398-3017-8 Handbook of Brachytherapy Jack Venselaar, Dimos Baltas, Peter J. Hoskin, and Ali Soleimani-Meigooni, Editors Proton and Carbon Ion Therapy ISBN: 978-1-4398-4498-4 Charlie C.-M. Ma and Tony Lomax, Editors ISBN: 978-1-4398-1607-3 Targeted Molecular Imaging Michael J. Welch and William C. Eckelman, Editors Monte Carlo Techniques in Radiation Therapy ISBN: 978-1-4398-4195-0 Jeffrey V. Siebers, Iwan Kawrakow, and David W. O. Rogers, Editors ISBN: 978-1-4398-1875-6 IMAGING IN MEDICAL DIAGNOSIS AND THERAPY William R. Hendee, Series Editor Quality and Safety in Radiotherapy Edited by Todd Pawlicki Peter B. Dunscombe Arno J. Mundt Pierre Scalliet Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business A TAYLOR & FRANCIS BOOK Taylor & Francis 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2011 by Taylor and Francis Group, LLC Taylor & Francis is an Informa business No claim to original U.S. Government works Printed in the United States of America on acid-free paper 10 9 8 7 6 5 4 3 2 1 International Standard Book Number-13: 978-1-4398-0437-7 (Ebook-PDF) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. 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CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com We dedicate this textbook to radiotherapy patients worldwide. Our hope is that it will result in further advances in the quality and safety of radiotherapy. Contents Series Preface ................................................................................................................................................ xi Preface.........................................................................................................................................................xiii Acknowledgments ........................................................................................................................................xv Contributors ..............................................................................................................................................xvii Part I Quality Management and Improvement 1 Perspective on Quality and Safety in Radiotherapy ..........................................................................................3 2 Quality as Viewed and Lived by the Patient ........................................................................................................7 3 Quality Management: An Overview ....................................................................................................................11 4 Quality Management: Radiotherapy ....................................................................................................................15 5 Development and Operation of a Quality Management Program: A Case Study ...............................................................................................................................................................19 6 Methodologies for Quality Improvement ...........................................................................................................23 7 Lean Thinking and Quality Improvement .........................................................................................................29 8 Process Control and Quality Improvement .......................................................................................................37 9 Access to Care: Perspectives from a Private Healthcare Environment ......................................................43 10 Access to Care: Perspectives from a Public Healthcare Environment .......................................................47 11 Cost of Quality: Health Technology Assessment .............................................................................................53 12 Past, Present, and Future of Quality in Radiotherapy ....................................................................................59 13 Past, Present, and Future of Quality in Radiotherapy Physics .....................................................................63 Part II Patient Safety and Managing Error 14 Issues in Patient Safety ............................................................................................................................................69 15 Overview of Risk Management ..............................................................................................................................73 16 Tools for Risk Management ....................................................................................................................................77 17 Error and Near-Miss Reporting: View from Europe .......................................................................................81 18 Error and Near-Miss Reporting: View from North America ........................................................................85 vii viii Contents 19 Impact of Cultural Biases on Safety .....................................................................................................................95 20 Primer on High Reliability Organizing ............................................................................................................101 21 Errors in Patient Information Flow ....................................................................................................................105 22 Identifying and Reducing Risk ............................................................................................................................111 23 New Paradigm for Quality Management in Radiation Therapy Based on Risk Analysis ...................115 24 Risk Analysis and Control for Brachytherapy Treatments ..........................................................................119 Part III Methods to assure and Improve Quality 25 Medical Indicators of Quality: Terminology and Examples .......................................................................143 26 Medical Indicators of Quality: Structure, Process, and Outcome .............................................................155 27 Role of Quality Audits: View from North America .......................................................................................161 28 Role of Quality Audits: View from the IAEA ..................................................................................................167 29 Peer Review: Physician’s View from Australia ................................................................................................171 30 Peer Review: Physicist’s View from North America ......................................................................................175 31 Overview of Credentialing and Certification .................................................................................................179 32 Approach to Radiation Oncology Practice Accreditation ............................................................................185 33 Clinical Trials: Credentialing ..............................................................................................................................191 34 Clinical Trials: Quality Assurance .....................................................................................................................197 35 Vendor’s Role in Quality Improvement .............................................................................................................209 Part IV People and Quality 36 Role of Leadership ...................................................................................................................................................219 37 Human Factors Engineering: Overview ............................................................................................................223 38 Human Factors Engineering: Radiotherapy Application .............................................................................229 39 Human Factors Engineering: Case Study .........................................................................................................235 40 Changing Role of the Radiation Oncologist ....................................................................................................241 41 Changing Role of the Medical Physicist ...........................................................................................................245 42 Staffing for Quality: Overview ............................................................................................................................249 43 Staffing for Quality: Physics ................................................................................................................................255 44 Role of Training .......................................................................................................................................................259 45 Practical Aspects of Training ..............................................................................................................................263 Part V Quality assurance in radiotherapy 46 CT Simulation ..........................................................................................................................................................269 47 MRI and MRS Simulation .....................................................................................................................................277 Contents ix 48 Image Registration, Fusion, and Segmentation ..............................................................................................283 49 4D Simulation ..........................................................................................................................................................291 50 Treatment Planning Systems ................................................................................................................................299 51 External Beam Radiotherapy ...............................................................................................................................305 52 Linear Accelerator: Resource Analysis for Commissioning ........................................................................311 53 Linear Accelerator: Implementation and Use ..................................................................................................317 54 Cobalt: Implementation and Use ........................................................................................................................323 55 Superficial and Orthovoltage: Implementation and Use ..............................................................................327 56 Computer-Controlled and Intensity-Modulated Radiotherapy .................................................................333 57 Intensity-Modulated Volumetric Arc Radiotherapy ......................................................................................343 58 Four-Dimensional Treatment ..............................................................................................................................349 59 Combined Planning and Delivery Systems ......................................................................................................353 60 Proton Radiotherapy ..............................................................................................................................................357 61 Stereotactic Radiosurgery and Stereotactic Radiation Therapy .................................................................361 62 Total Body Irradiation ...........................................................................................................................................373 63 High Dose Rate Brachytherapy ...........................................................................................................................381 64 Electronic Brachytherapy ......................................................................................................................................397 65 Technical Guidance Documents .........................................................................................................................405 Part VI Quality Control: Equipment 66 Dosimetry Equipment and Phantoms ................................................................................................................411 67 Conventional Simulators .......................................................................................................................................417 68 Computed Tomography, Positron Emission Tomography, and Magnetic Resonance Imaging .........419 69 Stand-Alone External Beam Treatment Planning Systems ..........................................................................433 70 Conventional Linear Accelerators ......................................................................................................................439 71 Linear Accelerator–Based MV and kV Imaging Systems .............................................................................443 72 Elekta Multileaf Collimator .................................................................................................................................447 73 Varian Multileaf Collimator ................................................................................................................................455 74 Siemens Multileaf Collimator ..............................................................................................................................461 75 Integrated Systems: Tomotherapy .......................................................................................................................465 76 Integrated Systems: GammaKnife ......................................................................................................................469 77 Integrated Systems: CyberKnife ..........................................................................................................................473 78 Stand-Alone Localization Systems: Ultrasound .............................................................................................479 79 Stand-Alone Localization Systems: Transponder Systems ..........................................................................483 80 Stand-Alone Localization: Surface Imaging Systems ....................................................................................491
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