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A Practice-based Taxonomy for Radiation Treatment Errors.

Catarina Lam1, Gaylene Medlam2, Anne Wighton3

  • 1Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Journal of Medical Imaging and Radiation Sciences
|May 5, 2019
PubMed
Summary
This summary is machine-generated.

A new radiotherapy error taxonomy was developed to improve knowledge sharing. This clinically relevant classification system, after iterative refinement and validation, achieved high agreement among practitioners for incident reporting.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Patient Safety

Background:

  • Lack of a standardized language for incident classification hinders knowledge sharing in radiotherapy.
  • This limitation impacts learning and improvement within and between healthcare organizations.

Purpose of the Study:

  • To develop a clinically relevant and standardized taxonomy for classifying radiotherapy errors.
  • To facilitate improved incident reporting and knowledge sharing in radiation oncology.

Main Methods:

  • A multicenter, prospective study involving three phases: taxonomy development, iterative revision using incident data, and face validity testing with practitioners.
  • Utilized the World Health Organization Conceptual Framework for the International Classification for Patient Safety.

Main Results:

  • The developed taxonomy includes seven classes: incident nature, impact, type, origin, discovery, contributing factors, and preventative strategies.
  • Initial face validity testing showed low agreement, but revisions based on feedback led to high interobserver agreement (70%-93%) in the second test.

Conclusions:

  • An iterative development process resulted in a workable, multidimensional taxonomy for radiotherapy incidents.
  • The taxonomy is scalable and can be implemented in incident databases to enhance learning across institutions.