ABSTRACT
Approximately 20,000 US veterans receive radiation oncology services at a Veterans Healthcare Administration (VHA) medical facility each year. They currently have access to advanced technologies, which include image-guided intensity-modulated radiotherapy, stereotactic radiosurgery, and stereotactic body radiation therapy. Although this provides access to cancer therapies that are modern, safe, and efficient, the technical complexities of these treatments and clinical decision making that goes into the patient selection and prescriptions demand quality assurances at each VHA practice. To meet the challenges of this need, the VHA established a partnership in 2008 with the ACR's Radiation Oncology Practice Accreditation Program (ACR-ROPA). This report summarizes the experience of this ongoing partnership and demonstrates the combined impact of the VHA's mandate for ACR-ROPA accreditation and internal monitoring of all identified corrective actions at each of its radiation oncology practices.
Subject(s)
Accreditation , Quality Improvement , Radiation Oncology/standards , Veterans Health/standards , Humans , Specialty Boards , Surveys and Questionnaires , United States , United States Department of Veterans AffairsABSTRACT
PURPOSE: The American College of Radiology (ACR) Radiation Oncology Practice Accreditation (ROPA) program has accredited more than 600 sites since 2006, including practices within academic, hospital-based, and freestanding settings. The purpose of this report is to evaluate and compare patterns of change in common deficiencies over time. METHODS AND MATERIALS: The ACR database was queried to analyze the common deficiencies noted by the ACR ROPA program between 2012 and 2014. Deficiencies were ranked and compared to the top 10 items that were reported in 2006. RESULTS: Between 2012 and 2014, 272 new applications and 306 renewals were received. Timely verification of port films, documentation of physician peer review, inclusion of essential elements of a treatment prescription, evidence of a final physicist chart review, documentation of weekly treatment visits, and inclusion of key elements of brachytherapy documentation all improved when compared with 2000-2005. Deficiencies ranked higher on the current review compared with the previous analysis included documentation of a robust quality assurance program, missing elements from the history and physical documentation, and documentation of follow-up visits. CONCLUSIONS: Our analysis of changes in patterns of deficiencies across radiation oncology practices reflects changes in our field such as the growing reliance on electronic records and imaging. Accreditation continues to play an integral role in establishing national standards and a nonpunitive, peer-reviewed method to evaluate a practice's compliance with national quality guidelines.
Subject(s)
Accreditation/methods , Quality Assurance, Health Care/methods , Radiation Oncology/standards , Humans , Quality Assurance, Health Care/standards , United StatesSubject(s)
Endoscopy/methods , Image Interpretation, Computer-Assisted/methods , Information Dissemination/methods , Medical Records Systems, Computerized/organization & administration , Radiology Information Systems/organization & administration , User-Computer Interface , Video Recording/methods , Database Management Systems/organization & administration , MassachusettsABSTRACT
Assuring quality in the practice of radiation oncology has become increasingly important because of the greater complexity of treatments and the advancing knowledge of the diseases that are treated. Increased public attention to errors in medicine, the increasing use of new imaging modalities to plan therapy, the availability of new therapeutic techniques such as intensity-modulated radiation therapy, and greater dependence on information technology have increased the need for intense quality assurance (QA) in the specialty. The process of QA and the resources available to radiation oncology staff members are described.
