Room: AAPM ePoster Library
Purpose: to the complexity of radiation oncology treatment planning and delivery system, it is either tedious or impractical to check every bit of essential information. Based on the variances reported to our QSRC (Quality and Safety Review Committee) reporting system, even experienced physicists cannot catch all the errors (sometimes very serious errors) during the physics initial chart check. This work reports the initial experience of the in-house auto chart check (IHACC) system based on TG-275 and TG-315 and our own clinical practice guidelines and data governance.
Methods: focuses on four aspects of chart check: 1. compliance check; 2. quality check; 3. deliverability check; 4. error check. This tool is implemented for most of the items mentioned in TG-275 and TG-315 as well as our own clinical practice guidelines with the help of scripting interface provided by the TPSs (Varian’s Eclipse and RaySearch’s RayStation). It also addresses weak spots in our clinical procedures identified by our QSRC. IHACC has recently been installed and implemented in the clinic and the resulting benefits in initial chart check practice are evaluated.
Results: covers 135 comprehensive check items and so far has been implemented for about 200 initial chart checks in our clinic. With IHACC, the manual chart check time may be reduced to 10min or less, regardless of plan complexity; some of manually impossible check items (e.g., the PTV margin and how proton beams pass the couch edge/wedge) can be efficiently quantified; several items that were frequently missed in the past (e.g., wrong field name, wrong machine tolerance table and prescription inconsistency) were correctly identified.
Conclusion: experience shows that IHACC is imperative for modern radiation oncology to greatly improve patient safety, chart check efficiency, practice uniformity, efficiency of resource utilization and yield financial benefits.