Clinical Audits Methodology of the Radiotherapy Departments in Russian Federation Based on IAEA Audits Principles

Abstract

Purpose: To describe the essence, tasks and algorithm of comprehensive audit in radiotherapy departments of medical institutions in Rus sian Federation. The methodology of audits conducted by the International Atomic Energy Agency (IAEA) and adapted for its further application, was used as a model. The global goal of the audit project is to standardize and harmonize procedures to ensure safety and quality control of treatment of cancer patients in different institutions, to enable comparison of radiation therapy results among participating institutions, to conduct interclinical studies and, possibly, to create a unified data register. Material and methods: One of the main aspects of clinical audits is the harmonization of standards between different departments. Clinical audits in radiotherapy can be an important tool for interclinical quality assurance (QA) program, effectiveness and safety of radiotherapy, and treatment protocols synchronization. Audits allow an in-depth analysis of the procedures and processes governing patient care in a particular clinic. Such clinical audits cover the whole chain of patients care, the organization of structural units, the infrastructure, clinical, physics and technical aspects underlying the radiotherapy department. This audit is a peer review process conducted by an audit team consisting of a radiation oncologist (RO), medical physicist (MP) and radiation technologist (RTT) and is known as QUATRO and stands for Quality Assurance Team in Radiation Oncology). Possible audit tools include: 1. Saff interviewing. 2. Examination of the structure of the entire department. 3. Review and evaluation of procedures and all relevant documentation, including analysis of patient charts. 4. Conducting independent measurements of absorbed doses and other methods of local procedures monitoring, where relevant and appropriate. 5. Observation of the practical implementation of operating procedures. Results: It was decided to use the IAEA QUATRO methodology for clinical audits and to adapt it to the specifics of radiotherapy in Russian Federation. One of the advantages of such a clinical audit is that the formalism and algorithm of this approach will be identically applied in all departments, which will allow comparing and analyzing the results. In order to obtain structured information, a detailed research protocol, which is a questionnaire, has been developed. The questions in the questionnaire allow to assess key aspects of the radiotherapy process that affect clinical outcomes and treatment efficiency.