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Methods of Documentation III: PIE

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Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:

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Related Experiment Video

Updated: Dec 14, 2025

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

Published on: April 11, 2018

Combining automatic plan integrity check (APIC) with standard plan document and checklist method to reduce errors in

Ping Xia¹, Danielle LaHurd¹, Peng Qi¹

¹Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.

Journal of Applied Clinical Medical Physics

|July 18, 2020

Summary

Combining automatic plan integrity checks (APIC), standard documentation, and checklists significantly reduced errors in radiation therapy planning. This integrated approach improved safety and efficiency in treatment planning processes.

Keywords:

automation planning errors radiotherapy standardization treatment plans

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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Published on: February 6, 2019

Area of Science:

Medical Physics
Radiation Oncology
Healthcare Quality Improvement

Background:

Treatment planning in radiation oncology is complex and prone to errors.
Minimizing errors in treatment planning is crucial for patient safety and treatment efficacy.
Existing methods for error detection and prevention require enhancement.

Purpose of the Study:

To evaluate the combined impact of automatic plan integrity check (APIC), standardized documentation, and checklist methods on minimizing treatment planning errors.
To assess the reduction in both the number and severity of errors in the radiation therapy planning process.

Main Methods:

Development and implementation of an automatic plan integrity check (APIC) program integrated into the treatment planning system.
Standardization of plan documentation through scripting and enforcement of APIC usage.
Utilization of checklist methods for identifying communication errors in patient charts.
Comparison of planning error rates before (2013-2014) and after (2015-2018) APIC implementation, categorizing errors by severity.

Main Results:

A significant reduction in the overall planning error rate was observed, decreasing from 3.4% before APIC to 1.5% per plan after implementation.
Error rates in serious (S) and near miss (NM) categories were markedly reduced, showing a statistically significant decrease from 0.6% to 0.1% (P < 0.01).
The combined methods led to a substantial decrease in planning errors across all severity categories.

Conclusions:

The integration of APIC, standardized documentation, and checklists effectively minimizes errors in the radiation therapy treatment planning process.
This multi-faceted approach significantly reduces both the frequency and severity of planning errors, enhancing patient safety.
The study demonstrates the successful clinical implementation of a robust system for quality improvement in radiation oncology planning.