Quality and Safety in Radiotherapy (Imaging in Medical Diagnosis & Therapy)

DESCRIPTION

The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers:

• Quality Management and Improvement includes discussions about lean thinking, process control, and access to services.
• Patient Safety and Managing Error looks at reactive and prospective error management techniques.
• Methods to Assure and Improve Quality deals broadly with techniques to monitor, assure, and improve quality.
• People and Quality focuses on human factors, changing roles, staffing, and training.
• Quality Assurance in Radiotherapy addresses the general issues of quality assurance with descriptions of the key systems used to plan and treat patients and includes specific recommendations on the types and frequencies of certain tests.
• Quality Control: Equipment and Quality Control: Patient-Specific provides explicit details of quality control relating to equipment and patient-specific issues.

Recently, a transformation of quality and safety in radiotherapy has begun to take place. Among the key drivers of this transformation have been new industrial and systems engineering approaches that have come to the forefront in recent years following revelations of system failures. This book provides an approach to quality that is long needed, one that deals with both human and technical aspects that must be the part of any overall quality improvement program.

Features

· Presents a global view of modern quality techniques that encourage improved patient care and safety
· Discusses both process and people specific approaches to quality monitoring and improvment
· Includes examples that highlight the use of modem quality techniques from manufacturing and engineering
· Emphasizes real-world scenarios to offer guidelines for setting up quality assurance programs and performing quality assurance procedures

TABLE OF CONTENTS

Part I Quality Management and Improvement

• A Perspective on Quality and Safety in Radiotherapy
• Quality as Viewed and Lived by the Patient
• Quality Management: An Overview
• Quality Management: Radiotherapy
• Development and Operation of a Quality Management Program: Case Study
• Methodologies for Quality Improvement
• Lean Thinking and Quality Improvement
• Process Control and Quality Improvement
• Access to Care: Perspectives from a Private Healthcare Environment
• Access to Care: Perspectives from a Public Healthcare Environment
• The Cost of Quality: Health Technology Assessment
• The Past, Present, and Future of Quality in Radiotherapy
• Past, Present, and Future of Quality in Radiotherapy Physics

Part II Patient Safety and Managing Error

• Issues in Patient Safety
• An Overview of Risk Management
• Tools for Risk Management
• Error and Near-Miss Reporting: A View from Europe
• Error and Near-Miss Reporting: A View from North America
• The Impact of Cultural Biases on Safety
• A Primer on High Reliability Organizing
• Errors in Patient Information Flow
• Identifying and Reducing Risk
• A New Paradigm for Quality Management in Radiation Therapy Based on Risk Analysis
• Risk Analysis and Control for Brachytherapy

Part III Methods to Assure and Improve Quality

• Medical Indicators of Quality: Terminology and Examples
• Medical Indicators of Quality: Structure, Process, and Outcome
• The Role of Quality Audits: A View from North America
• The Role of Quality Audits: A View from the IAEA
• Peer Review: A Physician’s View from Australia
• Peer Review: A Physicist’s View from North America
• An Overview of Credentialing and Certification
• An Approach to Radiation Oncology Practice Accreditation
• Clinical Trials: Credentialing
• Clinical Trials: Quality Assurance
• The Vendor’s Role in Quality Improvement

Part IV People and Quality

• The Role of Leadership
• Human Factors Engineering: An Overview
• Human Factors Engineering: A Radiotherapy Application
• Human Factors Engineering: A Case Study
• The Changing Role of the Radiation Oncologist
• The Changing Role of the Medical Physicist
• Staffing for Quality: Overview
• Staffing for Quality: Physics
• The Role of Training
• Practical Aspects of Training

Part V Quality Assurance in Radiotherapy

• CT Simulation
• MRI and MRS Simulation
• Image Registration, Fusion, and Segmentation
• 4D Simulation
• Treatment Planning Systems
• External Beam Radiotherapy
• Linear Accelerator: Resource Analysis for Commissioning
• Linear Accelerator: Implementation and Use
• Cobalt: Implementation and Use
• Superficial and Orthovoltage: Implementation and Use
• Computer-Controlled and Intensity-Modulated Radiotherapy
• Intensity-Modulated Volumetric Arc Radiotherapy
• Four-Dimensional Treatment
• Combined Planning and Delivery Systems
• Proton Radiotherapy
• Stereotactic Radiosurgery and Stereotactic Radiation Therapy
• Total Body Irradiation
• High Dose Rate Brachytherapy
• Electronic Brachytherapy
• Technical Guidance Documents

Part VI Quality Control: Equipment

• Dosimetry Equipment and Phantoms
• Conventional Simulators
• Computed Tomography, Positron Emission Tomography, and Magnetic Resonance Imaging
• Stand-Alone External Beam Treatment Planning Systems
• Conventional Linear Accelerators
• Linear Accelerator–Based MV and kV Imaging Systems
• Elekta Multileaf Collimator
• Varian Multileaf Collimator
• Siemens Multileaf Collimator
• Integrated Systems: Tomotherapy
• Integrated Systems: GammaKnife
• Integrated Systems: CyberKnife
• Stand-Alone Localization Systems: Ultrasound
• Stand-Alone Localization Systems: Transponder Systems
• Stand-Alone Localization: Surface Imaging Systems
• Mobile Electron Beam Intraoperative Radiation Therapy
• Proton Radiotherapy
• High-Dose-Rate Brachytherapy

Part VII Quality Control: Patient-Specific

• External Beam Plan and MU Checks
• Monte Carlo
• Patient Setup
• Motion Management
• Total Skin Electron Therapy
• Total Body Irradiation and Intensity-Modulated Total Marrow Irradiation
• Tomotherapy
• CyberKnife
• Multileaf Collimator-Based Intensity-Modulated Radiotherapy
• Compensator-Based Intensity-Modulated Radiotherapy
• Cranial Stereotactic Radiosurgery and Stereotactic Radiotherapy
• Stereotactic Body Radiation Therapy
• Proton Radiotherapy
• High-Dose-Rate Brachytherapy
• Low-Dose-Rate Brachytherapy
• Brachytherapy with Unsealed Sources
• Intravascular Brachytherapy

AUTHOR BIOGRAPHY

Todd Pawlicki and Arno J. Mundt work in the Department of Radiation Oncology at the University of California, San Diego.

Peter Dunscombe works in the medical physics department at the Tom Baker Cancer Center.

Pierre Scalliet works in the Department of Radiation Oncology at the St. Luc University Hospital.