Review of Quality Audit in a Radiation Oncology Department in a Tertiary Care Hospital– 2 Year-Results

Document Type : Research Articles

Authors

Department of Radiation Oncology, Sir H.N Reliance Foundation Hospital, Mumbai, Maharashtra, India.

Abstract

Objectives: This study aimed to report the findings of comprehensive weekly quality audit of radiotherapy procedures conducted at our institute, assessing various domains including clinical notes, contour delineation, treatment planning, prescription accuracy, patient-specific quality assurance, and treatment set-up checks. Material and Methods: The audit protocol, based on the Peer Review Audit Tool (PRAT) from the Royal Australian and New Zealand College of Radiologists, evaluated six critical parameters: clinical decisions, contours, treatment prescriptions, plan evaluation, plan quality assurance, and daily treatment set-ups. Patients were assessed for changes categorized as no change, minor change, or major change. The audit panel comprised radiation oncologists, medical physicists, and therapists. The audit is conducted on a weekly basis, including patients who initiated treatment within the preceding week. Results: Between December 2020 to October 2023, 1831 cases were treated with radiotherapy in our institution and all of them were included in the quality audit. Overall, majority of patients exhibited no changes across various domains, with minor adjustments noted in a small percentage of cases. Notably, the clinical note check domain showed 99% adherence to standards, while contour delineation and treatment planning domains displayed minor adjustments in 2.7% and 1.7% of cases, respectively. Prescription accuracy and patient-specific quality assurance demonstrated high compliance, with minimal changes observed. Treatment set-up checks revealed minor variations in 0.3% and major changes in 0.2% of cases. Conclusion: This study underscores the importance of comprehensive quality audits in radiation oncology to ensure precision and consistency in treatment delivery. By identifying potential areas for improvement and maintaining high standards across all stages of the radiotherapy process, such audits play a crucial role in optimizing treatment outcomes and enhancing patient safety.

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