Room: Exhibit Hall
Purpose: In our mid-sized academic center (5 linacs, 8 physicists) the institution provides a project manager for large projects (e.g. new linear accelerator or R&V software). In 2016 the practice determined a need for a TSE (Total Skin Electron) treatment program, but this did not involve a project manager. We identified this as an opportunity to utilize the FMEA (Failure Modes and Effects Analysis) strategies laid out in TG-100, not just for developing a risk-based quality assurance program, but to serve a project management role driving the workflow design for the practice.
Methods: A multidisciplinary team consisting of a facilitator (physicist), two project physicists, one dosimetrist, one physician, one therapist and two scheduling staff was assembled to complete the FMEA. The group met over the course of 4 months; for 2-4 hours weekly, and sometimes worked individually offline too. Process maps were divided by area, and were completed at a detail level sufficient to ensure understanding among non-experts. The RPN scoring was done collaboratively.
Results: The clinical implementation of the TSE program was streamlined and efficient, and we had little confusion about the workflow steps, flowing from referral to consultation, scheduling, simulation, planning, quality assurance and treatment. This was because of the enthusiastic team, complete process mapping, and thorough evaluation of each step. The facilitator was essential to taking a global view, aligning the different workgroups, and keeping the schedule.
Conclusion: FMEA served as a very effective project management tool, and was instrumental to create a process with a logical and efficient workflow. In the year since completion, we have had to make few changes to our workflow, thanks to the thoughtfulness of the original design. This was our first clinical application of FMEA, and it makes a strong case to commit resources to use FMEA for other practice areas.