International Conference on Advances in Radiation Oncology #ICARO2

Quality Assurance Team for Radiation Oncology (QUATRO) audit to the Institute of Oncology and Radiology of Serbia: example of good impact on the development of radiotherapy in the institution

21 Jun 2017, 11:40

10m

M1

Oral Presentation QA/QC Session 11b - Quality in Radiotherapy: various dimensions

Speaker

Suzana Stojanovic-Rundic (Department of Radiotherapy, Institute for Oncology and Radiology of Serbia; Faculty of Medicine University of Belgrade)

Description

Institute of Oncology and Radiology of Serbia (IORS) is the largest oncology institution in Serbia, dealing with cancer prevention, health care and treatment of malignant disease. Also IORS serves as a teaching base for Faculty of Medicine. Due to external and internal problems in Serbia in the last decade of the twentieth century, the problems and difficulties have been accumulated in field of radiotherapy. We were partially aware of our drawbacks so we requested a QUATRO audit from the IAEA. The main goal was to get an objective evaluation of the current situation and facilities, and to get guidelines for improvement of our radiotherapy department according to IAEA/ ESTRO established standards. The QUATRO audit was approved and conducted in March 2006 (13-17th) by an IAEA audit team. Auditors had full disclosure to all documents, facilities and protocols. All our staff members were very cooperative, active and answered to all given questions and requests from the auditors. IAEA Audit team report was completely objective and according to our situation in Radiotherapy Department. It revealed a significant amount of shortcomings in our protocols, QA/ QC procedures and guidelines. Moreover, auditors had many negative comments on our equipment and the lack of some essential radiotherapy devices and staff. After the IAEA mission we made some steps forward in order to improve the technology infrastructure in IORS and to adjust the clinical practice according to the established standards and suggested policy by the IAEA. We arranged many meetings with Government authorities in the attempt to acquire more funding. That resulted in the purchase of new crucial equipment suggested in the IAEA report: a CT simulator, Ro simulator, 3 new LINACs, dosimetry, QA and mould room equipment. On our part we made new written protocols and procedures; redesigned treatment sheets; continued to create institutional RT protocols; started implementing 3DCRT in most localizations; employed more RTT, physicists and physicians; devised a quality management system; defined the new educational programme for RT technicians according to ESTRO curriculum and started a postgraduate study in radiation oncology. We also planned to start a postgraduate study for medical physicist. We requested a follow-up audit to asses our development. The follow-up audit was approved and conducted from 7-9 December 2009 by the same audit team as in the first visit. The QUATRO team observed positive developments in our department. Substantial improvement in developing the infrastructure, logistics, and equipment upgrades had been achieved. Moreover, the audit team observed outstanding performance in some treatment units and concluded that our equipment is up-to-date. The overall impression of the follow-up visit was that IORS has been able to implement the recommendations of the lst QUATRO audit for significant improvement of both in technology and practice. The audit team concluded that with similar compliance to the recommendations of the follow up audit, there is a good chance to develop the department further with the goal of achieving the level of practice that fulfils the requirements of a center of competence. We are still working hard to further improve the situation in the Radiotherapy department of IORS and still use the QUATRO report recommendations as guidelines to achieve our goals to become a highly professional and effective service of evidence-based radiotherapy which follows the IAEA, ICRU and ESTRO criteria.