Radiation Therapy Quality Assurance

A treating facility that is not accredited by American College of Radiology (ACR), American Society for Radiation Oncology (ASTRO), or the American College of Radiation Oncology (ACRO) is required to audit and maintain reports of adherence to the following radiation quality assurance points. This information will be reviewed by the NAPBC surveyor during site visit.

Equipment Quality Assurance . Daily, monthly and annual physics calibration and output checks on all radiation equipment are performed that comply with the American Association of Physicists in Medicine (AAPM) guidelines (Machine Specific QA).

Patient Specific Quality Assurance . Assure system(s) for independent verification of initial dose calculations prior to administration of the third treatment and for weekly checks of all delivered doses. . Medical physicists supervise and approve calculations for all treatment plans. . Perform quality assurance checks of Intensity Modulated Radiation Therapy (IMRT) and Stereotactic Radiosurgery (SRS and SBRT) plans prior to treatment. . Policy & Procedure in place for therapist staff to review plans to verify agreement between the radiation dose in the treatment plan and the treatment machine. . Perform a “time-out” prior to administration of therapy to verify the physician’s written order, the prescribed dose programmed into the machine, and the patient identity for every new or changed treatment.

Personnel-Specific Quality Assurance . Assure proper credentialing based on field. . Conduct audits to ensure that staffing and time-out verifications are appropriate o First treatment time-out audit o Daily treatment time-out audits . Staff a minimum of two therapists per treatment unit

Overall Program Quality Assurance . Formal quality assurance & improvement program should include; chart rounds, new patient rounds, and presentation at a Morbidity and Mortality Conference. . Comply with regulatory requirements of accrediting agency. . Engage in a radiation oncology peer-review program that includes a focus on quality assurance for a minimum of 10% of all cases managed with in a Radiation Oncology practice.