AAPM Task Group 275 -- The...
Transcript of AAPM Task Group 275 -- The...
![Page 1: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/1.jpg)
AAPM Task Group 275 -- The Survey --
Luis Fong de los Santos Ph.D.
![Page 2: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/2.jpg)
Objec8ves: • Review:
I. Goal and Structure of TG 275 Survey. II. Survey Aggregate data and Global results. III. Ini8al results of Survey vs. FMEA cross-‐
reference.
![Page 3: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/3.jpg)
TG 275 Members
AAPM Supporting Staff
Survey
![Page 4: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/4.jpg)
TG 275 Goal • Develop recommenda8ons for:
• Ini8al Plan Check • On-‐Treatment Chart Check • End-‐of-‐Treatment Chart Check
Survey FMEA Evaluation + How?
![Page 5: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/5.jpg)
Treatment Modali8es
External Beam Brachytherapy
Photons Protons AAPM - Brachytherapy Subcommittee
Regina K. Fulkerson, PhD Wayne M. Butler, PhD
In progress …
![Page 6: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/6.jpg)
Survey -‐ Structure and Format
Ini8al Plan Check
On-‐ Treatment Chart Check
End-‐of-‐Treatment Chart Check Ford et al.: Incident learning structure. Med. Phys. 39 (12), 2012
q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
Survey
q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
![Page 7: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/7.jpg)
Incen8ves for Par8cipa8on • Opportunity to fulfill Part 2 MOC for Self-‐Assessment CE
(up to 15 hours of SA-‐CE) and Part 4 MOC requirement for PQI Ac8vity.
• Enrollement in a raffle for a complementary mee8ng registra8on.
• Opportunity to compare your specific response to the global average of all par8cipants.
• Promote survey using social media (e.g. LinkedIn, AAPM bulle8n boards)
![Page 8: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/8.jpg)
Survey Content and Valida8on • 55 Demographics Ques8ons:
– 18 -‐> General – 20 -‐> Ini8al Plan Check – 17 -‐> On-‐Treatment Chart Check
• 256 Items Check or Review: – 151 -‐> Ini8al Plan Check – 38 -‐> Proton Specific Ini8al Plan Check – 52 -‐> On-‐Treatment Chart Check – 15 -‐> End-‐of-‐Treatment Chart Check
15 – 30 minutes
![Page 9: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/9.jpg)
Data Collec8on • Surveying Period:
– Open for 7 Weeks (From Feb 10th to March 31st 2016)
• The tool that was used for the Survey: – Ques8onPro
AAPM Supporting Staff
![Page 10: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/10.jpg)
1526 Total Par8cipants: • 1310 from US, • 60 from Canada, • 107 from 35 other coun8es, • 49 were le` blank for this ques8on
![Page 11: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/11.jpg)
TG 275 -‐ Response Rate • Expected response rates for this type of survey:
– 10 to 40% • Our Survey:
– AAPM membership in Radiotherapy: ~4500 members – Response Rate: ~ 33%
![Page 12: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/12.jpg)
Academic(affiliated,hospital,
31%,
Community,hospital,39%,
Government,hospital,7%,
Free,Standing,Clinic,19%,
Consul@ng,Group,2%,
Vendor,0%,
Other:,2%,
<50$39%$
51$)100$34%$
>100$27%$
Type of Ins?tu?on Average No. of Pa?ents Treated Daily (Prac?ce Size)
![Page 13: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/13.jpg)
Panoramic View of the Results of the Survey
![Page 14: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/14.jpg)
Survey -‐ Structure and Format
Ini?al Plan Check
On-‐ Treatment Chart Check
End-‐of-‐Treatment Chart Check Ford et al.: Incident learning structure. Med. Phys. 39 (12), 2012
q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
Survey
q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ q -‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
151 Checks
52 Checks
15 Checks
![Page 15: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/15.jpg)
Items Checked during Ini?al Plan Check Process
![Page 16: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/16.jpg)
Items Checked during Ini?al Plan Check Process
![Page 17: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/17.jpg)
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Glob
al&Agreemen
t&on&Ite
ms&C
hecked
&[%]&
High Level Low Level Agreement
Items Checked during Ini?al Plan Check Process Sorted By Level of Agreement
Items Checked
N = 151
![Page 18: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/18.jpg)
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Glob
al&Agreemen
t&on&Ite
ms&C
hecked
&[%]&
High Level Low Level Agreement
Items Checked during Ini?al Plan Check Process Sorted By Level of Agreement
Items Checked
90% or beier agreement in 25% of the items checked
75% or beier agreement in 50% of the items checked
N = 151
![Page 19: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/19.jpg)
Items Checked during Ini8al Plan Check with Lowest Level of Agreement
Clinical Process Item Check Level of Agreement
Patient Assessment Diagnosis definition including imaging and outside records 37% Patient Assessment Consult Note 35% Patient Assessment Patient Consent 29% Patient Assessment Utilization of other treatment modalities (i.e. chemo, surgery) 25% Patient Assessment Pathology Report 19%
Patient Assessment Peer review of treatment decision (e.g. tumor board, peer-to-peer evaluation, etc.) 17%
Patient Assessment Insurance Approval 11% Simulation CT Scanner technique (e.g. kV, filter, etc.) 19% Simulation Transfer of images to archiving system 15% Simulation - Motion Management Gating parameters 23% Treatment Planning- Contouring Approval of contours by MD 29%
![Page 20: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/20.jpg)
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Glob
al&Agreemen
t&on&Ite
ms&C
hecked
&[%]&
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Globa
l&Agreemen
t&on&Item
s&Ch
ecked&[%
]&
On-‐Treatment Chart Check End-‐of-‐Treatment Chart Check
Number of Items Checked: 52 (a) 90% or beier agreement in 8% of the items checked (b) 75% or beier agreement in 37% of the items checked
(a)
(b)
Number of Items Checked: 15 (a) 90% or beier agreement in 20% of the items checked (b) 75% or beier agreement in 40% of the items checked
(a)
(b)
![Page 21: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/21.jpg)
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Glob
al&Agreemen
t&on&Ite
ms&C
hecked
&[%]&
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Globa
l&Agreemen
t&on&Item
s&Ch
ecked&[%
]&
On-‐Treatment Chart Check End-‐of-‐Treatment Chart Check
![Page 22: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/22.jpg)
Academic vs. Community Centers in USA
0.0#
10.0#
20.0#
30.0#
40.0#
50.0#
60.0#
70.0#
80.0#
90.0#
100.0#Glob
al&Agreemen
t&on&Ite
ms&C
hecked
&[%]&
Academic#
Community#
High Level Low Level Agreement Items Checked
![Page 23: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/23.jpg)
Items Checked depending on the RadOnc Informa?on System
High Level Low Level Agreement Items Checked
![Page 24: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/24.jpg)
Are ini8al plan check prac8ces sta8s8cal significance different depending on specific demographics?
Number of days to complete a plan check:
Debbie Schofield’s Session
![Page 25: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/25.jpg)
0.0%$
10.0%$
20.0%$
30.0%$
40.0%$
50.0%$
60.0%$
70.0%$
80.0%$
90.0%$
100.0%$
Glob
al&Agreemen
t&on&Ite
ms&C
hecked
&[%]&
Items Checked
TG -275 Next Milestone
Survey FMEA Evaluation +
Mapping of Current Practices
What’s Most Important
![Page 26: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/26.jpg)
TG 275 FMEA vs. Survey cross-‐reference
FMEA – Failure modes RPN Score
Survey – Percent use of che
ck
Low % Low RPN
High % Low RPN
Low % High RPN
High % High RPN
![Page 27: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/27.jpg)
TG 275 FMEA vs. Survey cross-‐reference
FMEA – Failure modes RPN Score
Survey – Percent use of che
ck
![Page 28: AAPM Task Group 275 -- The Surveyamos3.aapm.org/abstracts/pdf/124-35006-405535-125795...Survey%I%Structure%and%Format Ini8al%Plan%Check% OnI%TreatmentChartCheck% EndIofITreatmentChartCheck%](https://reader033.fdocuments.in/reader033/viewer/2022060716/607c03a37972070305386554/html5/thumbnails/28.jpg)
AAPM Community
Thank you!!