A Comprehensive Analysis of a Prospective Multidisciplinary Peer Review Process Before Radiation Therapy Simulation

Area of Science:

• Radiation Oncology
• Medical Physics
• Quality Improvement

Background:

• Peer review in radiation oncology (RO) is recommended for enhancing care quality.
• Empirical data on modifications from RO multidisciplinary presimulation standardized review is lacking.

Purpose of the Study:

• To analyze modifications resulting from a standardized RO multidisciplinary presimulation review process.
• To demonstrate the empirical impact of this quality improvement initiative.

Main Methods:

• A standardized simulation directive was used for external beam radiation therapy patients.
• Simulation directives underwent multidisciplinary review by key RO disciplines.
• Modifications were prospectively captured in a quality improvement registry and analyzed.

Main Results:

• Of 500 simulations, 21% of directives (105/500) were modified.
• A total of 149 modifications were made, primarily concerning patient positioning/immobilization (20%).
• More complex treatments (IMRT/SRS/SBRT) showed a higher modification rate (25% vs. 16%, P < .025).

Conclusions:

• Standardized directives and multidisciplinary presimulation peer review are vital for optimizing RO processes and reducing errors.
• Approximately 1 in 5 patients benefit from this review, particularly those receiving advanced treatments.
• This process enhances the quality of care in radiation therapy simulation.