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Comprehensive audit

Introduction

It is entirely possible to audit a part of an organization’s operation, for example, in radiotherapy the treatment machine calibration and dosimetric accuracy, or to assess all the processes and equipment employed for the successful treatment of the patient. Given the critical interplay between people and machines in radiotherapy, reviewing all the processes and equipment involved in the care of the patient from referral to discharge provides a more comprehensive overview of programme quality.

Important Principles

The IAEA’s Comprehensive Audit is performed by a team of at least three senior radiotherapy professionals – a radiation oncologist, medical physicist and radiation therapist – who spend 3 – 5 days on site at the facility. The auditors follow a well designed protocol and they have all received additional training in auditing procedures. The audit itself comprises a review of policies and procedures, a review of the treatment planning system database and the quality assurance program as well as in-depth discussions with upper level and front line staff. In all, 37 multi-item checklists are completed during the site review. The medical physicist member of the team also makes dosimetric measurements on the treatment units. A preliminary assessment of the programme is provided to the institution at the conclusion of the visit followed some time later by a detailed written report with recommendations for quality improvement. Adoption of the reviewers’ recommendations is purely at the discretion of the institution.

Introduction to References

An overview of auditing in general is provided in the text book chapter. Details of the comprehensive on-site auditing process, including the 37 checklists, are provided in the IAEA booklet.

Role of Quality Audits: View from the IAEA. J. Izewska and Eeva Salminen. In Quality and Safety in Radiotherapy. Eds T. Pawlicki et al. CRC press

Comprehensive Audits of Radiotherapy Practices: A Tool for Quality Improvement Quality Assurance Team for Radiation Oncology (QUATRO)