David J Hoopes1, Adam P Dicker2, Nadine L Eads3, Gary A Ezzell4, Benedick A Fraass5, Theresa M Kwiatkowski6, Kathy Lash7, Gregory A Patton8, Tom Piotrowski9, Cindy Tomlinson3, Eric C Ford10. 1. Department of Radiation Medicine and Applied Sciences, UC San Diego Moores Comprehensive Cancer Center, San Diego, California. Electronic address: dhoopes@ucsd.edu. 2. Department of Radiation Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania. 3. American Society for Radiation Oncology, Fairfax, Virginia. 4. Department of Radiation Oncology, Mayo Clinic Arizona, Scottsdale, Arizona. 5. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California. 6. American Association of Medical Dosimetrists, Herndon, Virginia. 7. Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan. 8. Compass Oncology, Portland, Oregon. 9. Clarity Group, Inc, Chicago, Illinois. 10. Department of Radiation Oncology, University of Washington, Seattle, Washington.
Abstract
PURPOSE: Incident learning is a critical tool to improve patient safety. The Patient Safety and Quality Improvement Act of 2005 established essential legal protections to allow for the collection and analysis of medical incidents nationwide. METHODS AND MATERIALS: Working with a federally listed patient safety organization (PSO), the American Society for Radiation Oncology and the American Association of Physicists in Medicine established RO-ILS: Radiation Oncology Incident Learning System (RO-ILS). This paper provides an overview of the RO-ILS background, development, structure, and workflow, as well as examples of preliminary data and lessons learned. RO-ILS is actively collecting, analyzing, and reporting patient safety events. RESULTS: As of February 24, 2015, 46 institutions have signed contracts with Clarity PSO, with 33 contracts pending. Of these, 27 sites have entered 739 patient safety events into local database space, with 358 events (48%) pushed to the national database. CONCLUSIONS: To establish an optimal safety culture, radiation oncology departments should establish formal systems for incident learning that include participation in a nationwide incident learning program such as RO-ILS.
PURPOSE: Incident learning is a critical tool to improve patient safety. The Patient Safety and Quality Improvement Act of 2005 established essential legal protections to allow for the collection and analysis of medical incidents nationwide. METHODS AND MATERIALS: Working with a federally listed patient safety organization (PSO), the American Society for Radiation Oncology and the American Association of Physicists in Medicine established RO-ILS: Radiation Oncology Incident Learning System (RO-ILS). This paper provides an overview of the RO-ILS background, development, structure, and workflow, as well as examples of preliminary data and lessons learned. RO-ILS is actively collecting, analyzing, and reporting patient safety events. RESULTS: As of February 24, 2015, 46 institutions have signed contracts with Clarity PSO, with 33 contracts pending. Of these, 27 sites have entered 739 patient safety events into local database space, with 358 events (48%) pushed to the national database. CONCLUSIONS: To establish an optimal safety culture, radiation oncology departments should establish formal systems for incident learning that include participation in a nationwide incident learning program such as RO-ILS.
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