An Audit for Radiotherapy Planning and Treatment Errors From a Low-Middle-Income Country Centre.

Area of Science:

• Radiation Oncology
• Medical Physics
• Healthcare Quality Improvement

Background:

• Low-middle-income countries (LMICs) often lack robust systems for reporting and learning from radiotherapy errors.
• Establishing baseline data on radiotherapy error rates, severity, and causes in LMICs is essential for improving patient safety.
• Existing error reporting mechanisms in developed countries can serve as a model for LMIC centers.

Purpose of the Study:

• To conduct an audit of radiotherapy errors in a LMIC setting.
• To determine the incidence, types, severity, and causes of radiotherapy errors.
• To provide baseline data for future quality improvement initiatives in LMIC radiotherapy centers.

Main Methods:

• A cross-sectional audit of electronic radiotherapy charts for 1005 consecutively treated patients.
• Errors were identified at the planning and delivery stages for curative intent treatments.
• Errors were graded using the institutional TREG system, and contributing factors were analyzed.

Main Results:

• 67 radiotherapy errors (42 incidents, 25 near-misses) were identified in 60 patients.
• Transcriptional errors were most common (29%), predominantly occurring during treatment planning (59.7%).
• Most errors were clinically insignificant (90%), with common causes including SOP non-adherence, poor documentation, and lack of education.

Conclusions:

• LMIC radiotherapy centers are vulnerable to errors, necessitating proactive safety measures.
• Development of prospective processes like voluntary reporting and continuous education is vital.
• Implementing systems comparable to those in developed countries can enhance radiotherapy safety in LMICs.