Podcasts + other contents Flashcards
According to the MRPBA Domain 5: Radiation safety and risk
manager, RTs must:
- Apply knowledge of equipment and instrumentation to confirm that it is in good order and operating within acceptable operating parameters.
- Identify and take action to correct unacceptable condition or operation of equipment and instrumentation.
- Follow protocols to record and report non-conformance of equipment.
it is the responsibility of the RTs to:
- Equipment includes all main equipment and accessory equipment (instruments) used to image or treat a patient/client.
- Good order may be achieved by following cleaning and hygiene protocols, calibration/testing regimes and acceptable operating standards.
- Issues affecting the functioning of equipment must be fully resolved before imaging or treating patients/clients
Daily CT QA checks
- lasers
- scale grid
- image quality (eg. CT# uniformity)
- resolution checks
The Process of Care + 5 categories
The “process of care” in radiation oncology refers to a framework for facilitating the appropriateness, quality and safety of all treatments received by patients undergoing
radiation therapy
- patient evaluation
- treatment preparation
- treatment delivery
- treatment management
- follow up evaluation and care
Routine daily QA on the LINAC
- Lasers
- Light field
- Field sizes
- Interlocks
- kV, MV, CBCT Units
- Beam – output and energy
- Mechanical devices
- Ancillary equipment
traditional role of an RT
- Provide safe and effective
delivery of radiation as
prescribed - Perform daily equipment
and new patient treatment
QA
evolving role of an RT
- Assessment of 2-D/3-D images to
make decisions concerning patient
alignment - Utilization of various motion
management equipment - Adapting to changing modalities
for IGRT and treatment (MRI
linacs, surface imaging, particle
therapy)
examples of tools and initiatives to facilitate safety and safety culture
- staffing and schedules
- standardisation
- communication and facilities
- lean methods
- risk analysis
- hierarchy of effectiveness
- systems and human factors engineering
- automated QA tools
- peer reviews
- daily morning huddles
- safety rounds
- routine public announcements and updates
- incident learning
- quality assurance committee
- credentialing and training of staff
peer review
is an essential part of the safe delivery of radiation and an important aspect of a lifelong learning program for the clinical team
compare QA and peer review
QA is often taken to relate to objective/quantitative “right versus wrong” actions (e.g., Was the correct plan sent from the TPS to the treatment machine? Is the machine beam output correct?) that can readily lead to major clinical events that affect one or many patients.
Peer review is often used to refer to somewhat more subjective items such as target definition or dose selection.
rationale of QA in RT
- reduces random and systematic errors across all steps in the process of care. This improves dosimetric and geometric accuracy and the precision.
- Increases the probability that they will be recognized and rectified sooner if they do occur, thereby reducing their consequences for patient treatment.
- Allows a reliable inter-comparison of results among different centres
- High level of accuracy and consistency is achieved- this is the expectation with highly conformal treatments.
Rationale for stringent QA
Cumulative Errors
- There are many contributing factors to overall uncertainty
- Understand and Optimize each component
- Need to optimise each component to the extent practical i.e., address the errors that can be controlled so that the errors that can’t be controlled matter less.
define Quality System Management (QSM)
is the management of a QA program
QSM is the management of a QA program. It involves establishing policies, procedures, and responsibilities to ensure the effective implementation and continuous improvement of QA processes.
define acceptance testing
Acceptance of equipment is the process in which the supplier demonstrates the baseline performance of the equipment to the satisfaction of the customer
is to verify that the new equipment meets the baseline performance specifications agreed upon with the supplier. It involves a series of tests and measurements performed by the supplier to demonstrate the equipment’s functionality and performance capabilities to the customer.
define commissioning
Commissioning is the process of preparing the equipment for clinical service
is the process of preparing the equipment for clinical service following acceptance testing. This involves a more comprehensive set of tests, calibrations, and adjustments performed by qualified medical physicists to ensure that the equipment is operating accurately, safely, and according to the manufacturer’s specifications and clinical requirements.