Pascale A M Simons1, Ruud Houben2, Jos Benders3, Madelon Pijls-Johannesma4, Dominique Vandijck5, Wim Marneffe6, Huub Backes7, Siebren Groothuis8. 1. Hasselt University, Faculty of Business Economics, Martelarenlaan 42, B-3500 Hasselt, Belgium. Electronic address: pascale.simons@uhasselt.be. 2. MAASTRO Clinic, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands; Dept. of Radiation Oncology (MAASTRO), GROW-School for Oncology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: ruud.houben@maastro.nl. 3. KU Leuven, Centre for Sociological Research (CESO), Parkstraat 45, B-3000 Leuven, Belgium. Electronic address: jos.benders@soc.kuleuven.be. 4. MAASTRO Clinic, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands; Dept. of Radiation Oncology (MAASTRO), GROW-School for Oncology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: madelon.pijls@maastro.nl. 5. Hasselt University, Faculty of Business Economics, Martelarenlaan 42, B-3500 Hasselt, Belgium; Ghent University, Faculty of Medicine and Health Sciences, De Pintelaan 185, B-9000 Ghent, Belgium. Electronic address: dominique.vandijck@uhasselt.be. 6. Hasselt University, Faculty of Business Economics, Martelarenlaan 42, B-3500 Hasselt, Belgium. Electronic address: wim.marneffe@uhasselt.be. 7. MAASTRO Clinic, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands. Electronic address: huub.backes@maastro.nl. 8. School for Public Health and Primary Care (Caphri), Department of Health Services Research, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: s.groothuis@maastrichtuniversity.nl.
Abstract
PURPOSE: To realize safe radiotherapy treatment, processes must be stabilized. Standard operating procedures (SOP's) were expected to stabilize the treatment process and perceived task importance would increase sustainability in compliance. This paper presents the effects on compliance to safety related tasks of a process redesign based on lean principles. METHOD: Compliance to patient safety tasks was measured by video recording of actual radiation treatment, before (T0), directly after (T1) and 1.5 years after (T2) a process redesign. Additionally, technologists were surveyed on perceived task importance and reported incidents were collected for three half-year periods between 2007 and 2009. RESULTS: Compliance to four out of eleven tasks increased at T1, of which improvements on three sustained (T2). Perceived importance of tasks strongly correlated (0.82) to compliance rates at T2. The two tasks, perceived as least important, presented low base-line compliance, improved (T1), but relapsed at T2. The reported near misses (patient-level not reached) on accelerators increased (P < 0.001) from 144 (2007) to 535 (2009), while the reported misses (patient-level reached) remained constant. CONCLUSIONS: Compliance to specific tasks increased after introducing SOP's and improvements sustained after 1.5 years, indicating increased stability. Perceived importance of tasks correlated positively to compliance and sustainability. Raising the perception of task importance is thus crucial to increase compliance. The redesign resulted in increased willingness to report incidents, creating opportunities for patient safety improvement in radiotherapy treatment.
PURPOSE: To realize safe radiotherapy treatment, processes must be stabilized. Standard operating procedures (SOP's) were expected to stabilize the treatment process and perceived task importance would increase sustainability in compliance. This paper presents the effects on compliance to safety related tasks of a process redesign based on lean principles. METHOD: Compliance to patient safety tasks was measured by video recording of actual radiation treatment, before (T0), directly after (T1) and 1.5 years after (T2) a process redesign. Additionally, technologists were surveyed on perceived task importance and reported incidents were collected for three half-year periods between 2007 and 2009. RESULTS: Compliance to four out of eleven tasks increased at T1, of which improvements on three sustained (T2). Perceived importance of tasks strongly correlated (0.82) to compliance rates at T2. The two tasks, perceived as least important, presented low base-line compliance, improved (T1), but relapsed at T2. The reported near misses (patient-level not reached) on accelerators increased (P < 0.001) from 144 (2007) to 535 (2009), while the reported misses (patient-level reached) remained constant. CONCLUSIONS: Compliance to specific tasks increased after introducing SOP's and improvements sustained after 1.5 years, indicating increased stability. Perceived importance of tasks correlated positively to compliance and sustainability. Raising the perception of task importance is thus crucial to increase compliance. The redesign resulted in increased willingness to report incidents, creating opportunities for patient safety improvement in radiotherapy treatment.
Authors: M Jacobs; L Boersma; A Dekker; E Hermanns; R Houben; M Govers; F van Merode; P Lambin Journal: Br J Radiol Date: 2015-02-13 Impact factor: 3.039
Authors: Mojtaba Vaismoradi; Susanna Tella; Patricia A Logan; Jayden Khakurel; Flores Vizcaya-Moreno Journal: Int J Environ Res Public Health Date: 2020-03-19 Impact factor: 3.390