Automating the initial physics chart checking process

The initial physics chart check, an essential quality assurance process, verifies that the physician intent is properly expressed in the treatment plan, the treatment plan is reasonable, and the Record and Verify (RV) system properly captures the plan parameters. In this work the process was automated by characterizing the initial physics chart check as a universal set of steps, compartmentalized into intra-plan and inter-plan reviews. The intra-plan review confirms the diagnosis-prescription-plan correlation, and verifies transfer accuracy of the signed treatment plan parameters into the RV system. The inter-plan review tabulates all RV parameters for similar cases, and highlights outliers. The tabulation of RV parameters for similar cases enables a summation of experience across staff members, and facilitates a comparison using the Statistical Process Control (SPC) formalism. A summary sheet, added to each reviewed chart, automatically documents deviations noted during the review process. Forty-five patient charts were analyzed using the software. The length of time for the entire initial chart-checking process was reduced from about an hour to a few minutes. The code developed in this work allows the user to consider the big picture, trusting the software to track details.