Practical implementation of quality improvement for high-dose-rate brachytherapy

Area of Science:

• Medical Physics
• Radiation Oncology
• Quality Improvement

Background:

• High-dose-rate (HDR) brachytherapy is a complex procedure with documented risks of serious errors.
• A need exists for robust quality improvement (QI) frameworks to enhance patient safety in HDR brachytherapy.

Purpose of the Study:

• To develop and implement a multidisciplinary quality improvement framework for HDR brachytherapy.
• To assess the impact of QI checklists on safety and efficiency in HDR brachytherapy delivery.

Main Methods:

• A department-wide multidisciplinary approach was used, including process mapping of the entire HDR program.
• Two types of checklists were developed: a safety-timeout checklist and detailed procedure checklists.
• Implementation involved staff training, visual guides, piloting, and compliance auditing.

Main Results:

• Process maps identified areas for improvement in treatment delivery.
• Safety-timeout checklists achieved 100% compliance; procedure checklists were used in 85% of fractions.
• Staff surveys indicated improved safety and benefits for cross-covering personnel.

Conclusions:

• A multidisciplinary approach successfully implemented process mapping and comprehensive checklists for HDR brachytherapy.
• The QI framework resulted in optimized departmental practices.
• This experience offers practical strategies for implementing similar changes in other institutions.