Comparison between the WHO-CFICPS and the PRISMA classification of safety-related events in a radiation oncology department.

INTRODUCTION: Describing Safety-Related Events (SREs) in a radiotherapy (RT) department and comparing WHO-CFICPS (World Health Organization's Conceptual Framework For The International Classification For Patient Safety) and PRISMA (Prevention and Recovery Information System for Monitoring and Analysis) methods for classifying SREs. METHODS: From February 2017 to October 2020, two Quality Managers (QMs) randomly classified 1173 SREs using 13 incident types of WHO-CFICPS. The same two QMs, reclassified the same SREs according to 20 PRISMA incident codes. Statistical analysis was performed to assess the association between the 13 incident types of WHO-CFICPS and the 20 PRISMA codes. The chi-squared and post-hoc tests using adjusted standardized residuals were applied to detect the association between the two systems. RESULTS: There was a significant association between WHO-CFICPS incident types and PRISMA codes (P < 0.001). Ninety-two percent of all SREs were categorized using 4 of 13 WHO-CFICPS incident types including Clinical Process/Procedure (n = 448, 38.2%), Clinical Administration (n = 248, 21.1%), Documentation (n = 226, 19.2%) and Resources/Organizational Management (n = 15,613.3%). According to PRISMA classification, 14 of the 20 codes were used to describe the same SREs. PRISMA captured 41 Humans Skill Slips from 226 not better defined WHO-CFICPS Documentation Incidents, 38 Human Rule-based behaviour Qualification from not better defined 447 Clinical Process/Procedure and 40 Organization Management priority events from 156 not better defined WHO-CFICPS Resources/Organizational Management events (P < 0.001). CONCLUSION: Although there was a significant association between WHO-CFICPS and PRISMA, The PRISMA method provides a more detailed insight into SREs compared to WHO-CFICPS in a RT department.

Crossover of the patient satisfaction surveys, adverse events and patient complaints for continuous improvement in radiotherapy department.

OBJECTIVE: The patient's needs and expectations can be assessed through satisfaction surveys, adverse event declarations and records of complaints. By cross-referencing individual complaints, satisfaction surveys and the adverse events received, we could get valuable information. The objective is to identify common elements of work between these different sources to improve care. METHODS: A retrospective analysis of patients' complaints, surveys and adverse events was carried out in order to highlight common improvement items between these three sources of information. RESULTS: A satisfaction survey was given to the patients at the end of their treatment, who filled it out and left it in the 'ad hoc' letterbox. At the end of December 2019, 4695 questionnaires had been collected (response rate 37%). In addition, since 2014, 1369 patients (∼20 patients per month) have been interviewed 'face to face' by the research nurse who assesses their satisfaction using open questions. At the same time, a collection of complaints and adverse events was carried out. All these data have been analysed and cross-checked in order to highlight areas for improvement and strengthen the safety and quality of care in our department. CONCLUSIONS: Collect and analyse satisfaction surveys, unexpected events and complaints constitute in our opinion, an effective tool to achieve patient empowerment. We aim for the patients to become a real player in their safety and involve in the overall effort to improve the quality of their radiotherapy treatment by reporting what does not meet their expectations.