“It’s a complex interchange of information and a handoff of information between these individuals,” says Hendee.

Given the intricacy of the technology and human interaction involved in the process, it’s no surprise that attendees of the meeting, hosted by AAPM and ASTRO, discussed strategies to improve communication processes in the interests of safety.


Recommendations for the staff

In his presentation at the meeting, Hendee told attendees that the radiotherapy treatment process must be fault-tolerant. Those involved in the planning and delivery must understand their responsibilities, learn from mistakes and engage in corrective actions. Although radiotherapy devices are highly computerized, human involvement is a part of the treatment process.

“We have to be able to recognize when errors occur and mistakes are made and correct the treatment by correcting those errors without letting them progress until a patient is adversely affected,” says Hendee. “We’ve had a lot of discussions with manufacturers about this. What we want is an early warning system built into the machine, so that if something is done that doesn’t seem right or it doesn’t match with what might be considered a standardized protocol for that particular type of patient and tumor, the machine will give an early warning.”

Although there is no set date for when the early warning systems will appear on radiotherapy equipment, it’s clear that OEMs favor this proposal. The radiotherapy community isn’t running into any opposition to this new feature, “but it requires changes in some pretty sophisticated protocols,” explains Hendee.

Another way to ensure safety during treatment is to focus the clinical team’s attention on the patient. At least two people should be at the console of the device for a checks and balances process, which might be a challenge in the current environment, says Hendee.

“Like a lot of businesses, many hospitals are undergoing rather restrictive budgetary limitations, but the worst thing you can do would be to limit the number of employees to such a degree that you put patients at risk,” he explains. “We have to emphasize to hospital administrators that the staffing levels must be appropriate, and to do that, we need to do some updating of our own information about staffing levels.”

About two years ago, AAPM came out with recommendations of staffing levels for different types of radiation therapy devices.
“But these systems have become much more complex, the accompanying technology has become much more complex and we haven’t updated those staffing levels. One of the first things we need is to reevaluate the recommended staffing levels and then encourage hospitals to pay attention to them,” says Hendee.

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