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Public Concerns in Radiation Oncology

DOS 516: Fundamentals of Radiation Safety
Sawyer Peterson

Events involving overexposure in radiation therapy have given public concern for the
safety of patients in radiation oncology. From these events, recognition arises to establish patient
safety cultures to maintain high quality care.1 National radiation safety regulations have provided
requirements for quality assurance programs in the radiation oncology field.2 The radiation
oncology discipline follows regulatory and quality assurance, which keeps error rates low.1
Participation in safety culture research can inform radiation therapy departments on important
safety culture components to be more prepared for future practice.1 Patient concerns can be
addressed with information about the current standards in the field today.
Public knowledge of the safety culture status within radiation oncology may ease
concerns regarding overexposure and mistakes. An article by Leonard and O’Donovan1 presented
results from a survey investigating the safety culture within radiation departments. Results found
that communication and teamwork within the radiation oncology team as well as continuous
learning improvement efforts were the strongest areas across multiple departments. Responses
indicated that a culture of safety is strongly encouraged, and the procedures are effective at
catching and preventing errors based on an 80 percent positive score from departments.1 The
study brings attention to the use of a risk analysis methods to prevent errors, and how the use of
nonpunitive error reporting and even better communication leads to a higher safety culture for
radiation therapy departments.1 While the article shows positive feedback among departments in
providing a safety culture through effective quality assurance and communication methods, it
also provides a source to show the public how the field is constantly looking to improve methods
to promote safety.
Current radiation standards for radiation oncology departments may also be helpful
information to the public. An article by Abdel-Wahab et al2 discusses the International Atomic
Energy Agency (IAEA) and their efforts to ensure safety while using radiation. The IAEA has
been involved with promoting radiation safety by establishing quality assurance programs and
quality control procedures. The program provides calibration and audit check services for
radiation beams, ensuring they are following standards, which helps prevent mistreatment of
patients.2 The IAEA has also created the basic safety standards which help improve patient and
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worker safety that include quality assurance processes, measurements, and establishing a
dosimetry code of practice. Educational and training requirements are also provided by the
agency to ensure all members of the radiation oncology team are properly trained.2 The
information regarding the IAEA and other agencies involved in the regulation of radiation
oncology departments and resources could be used to educate the public on the strict protocols
that are followed within the field. Being knowledgeable in the multiple guidelines the IAEA
oversees can provide examples on how safety is a top priority in each department.
Radiation oncology departments are also responsible for providing a culture of safety and
making improvements where needed. When radiation oncology departments were surveyed, the
largest area in need of improvement was communication between department handoffs and shift
changes.1 A lack of communication regarding important patient information may lead to adverse
effects, and it is recommended that a shift change checklist be implemented to provide better
communication. Another area of concern is the lower rate of event reporting, which is likely due
to the fear of penalization for the events. Reporting errors is key in preventing future events and
mistakes from occurring and increases patient safety through awareness and implementation of
solutions.1 By improving areas of further communication and nonpunitive event reporting,
departments can further improve their culture of safety by making fewer mistakes and making
information about events known to provide helpful information.
Departments should also be following the standards set by the IAEA and other regulatory
agencies to ensure accuracy and safe conditions. The IAEA provides clinical research that
provides information on treatment improvements and resource sparing interventions.2 Training
requirements were different for medical physicists across the world, and different programs
lacked critical components in education. The agency created standards for education, and helped
create specific requirements for ethe education of radiation oncologists and radiation therapists
that cover important topics in the radiation oncology field. Continuing education programs
through the IAEA can be utilized to increase awareness and keep departments up to date on the
best procedures in the field.2 While all standards need to be followed, it is important for
departments to stay up to date with the regulations and follow recommendations from agencies
that increase safety for both patients and workers.
Radiation oncology is a highly regulated practice that has had low rates of incidents and
errors.1 The IAEA provides mechanisms that provide safe and effective radiation treatments
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across may different member states.2 Safety is an important concern for both the public and the
clinics that provide treatment. It is important that healthcare providers in these departments work
with this awareness and continue to improve in patient safety areas.1 Continuous learning from
error reporting, following set protocols, and having clear communication leads to an increase in
patient safety and awareness.
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References

1. Leonard S, O’Donovan A. Measuring patient safety: Application of the hospital survey

on patient safety culture to radiation therapy departments worldwide. Practical Radiation
Oncology. 2018;8(1):e17-e26. doi:10.1016/j.prro.2017.08.005
2. Abdel-Waheb M, Zubizarreta E, Polo A, Meghzifene A. Improving quality and access to
radiation therapy-An IAEA perspective. Seminars in Radiation Oncology.
2017;27(2):109-117. doi:10.1016.j.semradonc.2016.11.001