ESTRO 38 Abstract book

S328 ESTRO 38

the coding key proposed by Izewska et al. (2). This taxonomy categorises these into four main divisions: issues pertaining to staffing, infrastructure, process or organisational factors. These are further subdivided into a 3-level categorisation code. Departments were also sent a questionnaire listing their recommendations and in which they were asked to evaluate the overall usefulness of the these as well as the usefulness and the actual impact of each individual recommendation based on an ordinal rating scale (see table 1).

10 minutes on average, that is, one interruption per treatment. Moreover, these TI are characterized as a physical disturbance, on the part of a health professional, of a duration less than a minute and intervening mainly when the RTT is at the linac console, so during its activity of registration (image matching) and treatment delivery. In terms of impact on activity, we found that the TI lead to a break in the progress of the activity, and when they undergo one or more interruptions in their treatment activity, the RTTs react in different ways depending on the type of interruption. We observed 2 types of reactions: they can either stop their action and process the second, then return to the first task when the second is over or continue their 2 actions simultaneously, so in pure multitasking mode. Results in figures 1 and 2.

Results Of the total of 381 emitted recommendations, 34% concerned process optimization. Twenty-seven percent of the recommendations concerned infrastructure (30% concerned the quality of the facility or the equipment). Finally, 19% and 20% of recommendations concerned organisational and staff issues respectively (e.g. RTT training and professional development).Twenty-three out of the 25 departments responded to the questionnaires. Fifty-four percent of the departments found the recommendations very useful. When scoring the usefulness of the individual recommendations, 42.7% were found to be very relevant with those pertaining to staff and organisation issues scored as being most relevant. When scoring the impact of the individual recommendations, 23.5% were deemed to have an important impact, the majority having a moderate impact (30.6%). Recommendations deemed to have the most impact were those pertaining to process optimisation. Conclusion Revisions of the emitted recommendations have allowed the auditors to identify, on a national basis, common areas of improvement. Similarly, the questionnaires have been able to demonstrate that the recommendations were globally deemed very relevant. However, the global impact of these on the department’s organisational/infrastructural situation was scored lower and this in majority due to factors outside of the department’s control. Encouraged by this analysis, a second cycle of audits has started in Belgium with a modified QUATRO document (B-QUATRO). OC-0619 Using continuous quality improvement to improve safety and reduce imaging errors in radiotherapy D. Tan 1 , L. Davies 1 , M. Williams 1 , S. Jones 1 , N. Bales 1 , C. Beswick 1 , P. Wheeler 1 1 Velindre Cancer Centre, Radiotherapy, Cardiff, United Kingdom Purpose or Objective A quality improvement (QI) project was implemented to facilitate the transition from standard two-dimensional megavoltage (2DMV) electronic portal imaging (EPI) to 2D kilovoltage (kV) imaging for the geometric verification of palliative indications within a radiotherapy (RT) department. Utilising QI methodologies, the aim of this work was to develop an image optimisation programme to ensure suitable image quality (using 2DkV imaging) whilst keeping doses as low as reasonably practicable (ALARP). It

Conclusion There are many TI in a RT department. This study allows us to highlight that TI can be a source of error and that there are a large number of elements on which it would be possible to act to limit risks. RTT activity is impacted by many TI, attention is diverted, activities are performed in multitasking mode. It is important to limit TI, to optimize the work environment, to set up a formalized task recovery. Multiple solutions are discussed: awareness of RTT to refuse to be interrupted, identify people who should not be interrupted and recover the interrupted task in a safe way. The next step will be to extend the observation of TI to all those involved in the RT workflow. OC-0618 Clinical audits as a quality improvement tool in radiotherapy departments: the Belgian experience A. Vaandering 1 , P. Scalliet 1 , F. Vanhoutte 3 1 UCL Cliniques Univ. St.Luc, Academic Department of Radiation Oncology, Brussels, Belgium ; 2 Belgian College for Physicians in Radiation Oncology, Brussels, Belgium ; 3 Ghent University Hospital, Department of Radiation Oncology, Ghent, Belgium Purpose or Objective The potential benefits of clinical audits are multiple and have the overall aim of encouraging continuous quality improvement through the implementation of corrective actions based on the recommendations emitted by the audits. A national project carried by the Belgian College of Radiotherapy brought about the instauration of systematic clinical audits of all radiotherapy (RT) departments using the IAEA QUATRO (Quality Assurance Team for Radiation Oncology) methodology from 2011 to 2015 included. The impact of these audits was then evaluated and the emitted recommendations were analysed to identify areas of weakness on a national basis. Material and Methods The QUATRO methodology is a peer-review based audit covering all parts of the RT process that gives rise to a report containing a detailed account of the audit including a list of recommendations that the department is encouraged to implement (1). The recommendations extracted from all 25 audit reports were classified using