Quality and Safety in Radiotherapy PDF

Preface

Quality and safety have always been important topics in the radiotherapy community. However, a single text that focuses on quality and safety does not exist. In attempting to provide such a reference, we decided to take the broadest possible view of quality and safety. We strove to encompass not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. In order to achieve these goals, we sought contributions from experts both inside and outside our field. Through the choice of authors, we have also attempted to present a global view of the topics covered.

We have been in the midst of a transformation of quality and safety in radiotherapy. Among the key drivers of this transformation have been new industrial and systems engineering approaches. These approaches have come to the forefront in recent years following revelations of system failures (in both the scientific and public press) that have harmed radiotherapy patients and compromised quality. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized for depending as much on processes and the people delivering the service.

This text is divided into seven broad categories. Part I, "Quality Management and Improvement," includes essays on the management and improvement of quality with topics such as lean thinking, process control, and access to services. Topics such as reactive and prospective error management techniques are covered in Part II, "Patient Safety and Managing Error." In Part III, "Methods to Assure and Improve Quality," we have grouped chapters that deal broadly with techniques to monitor, assure, and improve quality. The chapters in Part IV, "People and Quality," focus on human factors, changing roles, staffing, and training. The final three sections of the book deal with what one may traditionally view as quality assurance and quality control in radiotherapy. Part V, "Quality Assurance in Radiotherapy," addresses the general issues of quality assurance with descriptions of the key systems used to plan and treat patients. Several chapters provide specific recommendations on the types and frequencies of certain tests where these are not covered elsewhere. In Part VI, "Quality Control: Equipment," and Part VII, "Quality Control: Patient-Specific," we have collected chapters that provide explicit details of quality control relating to equipment and patient-specific issues.

The contributions dealing with topics that are still in development provide our best current knowledge of, and guidance for, quality assurance and control in these areas. Recommendations may change in the future but we expect that many components presented here will remain relevant. While the technical details of this book may be superseded by future advances, we hope that the core contents presented here will be useful to the field for many years to come.