Algorithms for the process management of sealed source brachytherapy

Incidents and misadministrations suggest that brachytherapy may benefit from clarification of the quality management program and other mandates of the U.S. Nuclear Regulatory Commission. To that end, flowcharts of step by step subprocesses were developed and formatted with dedicated software. The overall process was similarly organized in a complex flowchart termed a general process map. Procedural and structural indicators associated with each flowchart and map were critiqued and pre-existing documentation was revised. "Step-regulation tables" were created to refer steps and subprocesses to Nuclear Regulatory Commission rules and recommendations in their sequences of applicability. Brachytherapy algorithms were specified as programmable, recursive processes, including therapeutic dose determination and monitoring doses to the public. These algorithms are embodied in flowcharts and step-regulation tables. A general algorithm is suggested as a template from which other facilities may derive tools to facilitate process management of sealed source brachytherapy.