Izewska, J., Salminen, E., “Role of quality audits: view from the IAEA”, Quality and Safety in Radiotherapy, 1st edn, (Pawlicki, T., Dunscombe, P.B., Mundt, A.J., Scalliet, P.,Eds), CRC Press, Boca Raton, Florida (2010) Ch. 28. ISBN 9781439804360
Belgian association of quality managers in radiotherapy and downloadable QMRT tool (guidelines for the implementation and the evaluation of a quality and risk management systems in radiotherapy departments)
It is entirely possible to audit a part of an organization’s operation, for example, in radiotherapy the treatment machine calibration and dosimetric accuracy, or to assess all the processes and equipment employed for the successful treatment of the patient. Given the critical interplay between people and machines in radiotherapy, reviewing all the processes and equipment involved in the care of the patient from referral to discharge provides a more comprehensive overview of programme quality.
The IAEA’s Comprehensive Audit is performed by a team of at least three senior radiotherapy professionals – a radiation oncologist, medical physicist and radiation therapist – who spend 3 – 5 days on site at the facility. The auditors follow a well designed protocol and they have all received additional training in auditing procedures. The audit itself comprises a review of policies and procedures, a review of the treatment planning system database and the quality assurance program as well as in-depth discussions with upper level and front line staff. In all, 37 multi-item checklists are completed during the site review. The medical physicist member of the team also makes dosimetric measurements on the treatment units. A preliminary assessment of the programme is provided to the institution at the conclusion of the visit followed some time later by a detailed written report with recommendations for quality improvement. Adoption of the reviewers’ recommendations is purely at the discretion of the institution.
Introduction to References
An overview of auditing in general is provided in the text book chapter. Details of the comprehensive on-site auditing process, including the 37 checklists, are provided in the IAEA publication Comprehensive Audits of Radiotherapy Practices: A Tool for Quality Improvements.