Gabriele Pietro, Malinverni Giuseppe, Bona Cristina, Manfredi Manuela, Delmastro Elena, Gatti Marco, Penduzzu Giovanni, Baiotto Barbara, Stasi Michele
Radiation Therapy Unit, Institute for Cancer Research and Treatment, IRCC, Candiolo, Turin, Italy.
Tumori. 2006 Nov-Dec;92(6):496-502. doi: 10.1177/030089160609200606.
A number of documents assess the need for quality assurance in radiotherapy, which must be constantly monitored and possibly improved. In this regard, a system that confirms the quality of a department has been suggested and quality indicators have been used to improve the quality of the service. The National Health Service (Istituto Superiore di Sanità) approved a National Research Project to increase the quality of radiotherapy. The aim of the present study was to analyze the practical feasibility and efficacy of the quality indicators elaborated by the National Health Service study group in a radiotherapy unit.
The voluntary accredited program was carried out by the Radiotherapy Department of IRCC in Candiolo from June to August 2002. We analyzed 8 of the 13 indicators according to the National Health Service Project. For this purpose, 133 consecutive patients treated in our Unit were analyzed, and the results are reported according to the appropriate indicator (number of staff related to patients treated, waiting list, case history accuracy, multidisciplinary approach, number of treatment plans performed by CT, number of fields per fraction, number of portal imaging performed per overall treatment, and patient satisfaction).
The number of professional staff related to the number of patients treated was easy to calculate and it could be the basis for further evaluation. The overall waiting time was 55.4 days, and it changed for different radiotherapy goals. We obtained 80% conformity in case-history accuracy. The number of multidisciplinary consultations performed ranged between 50% and 100%. The number of CT plans was about 1.6 +/- 0.9 plans per patient. The mean number of fields performed per day and per patient is 3.5 +/- 1.7 and was in agreement with the fact that more than 50% of treatments in our Center were performed with conformal radiotherapy. An average of 16.7 +/- 10.0 portal imaging per case was performed. The percentage of patient satisfaction with the staff obtained a very high compliance.
The self evaluation promoted by the National Health Service Project allows the monitoring of the activities of the service in order to asses critical factors and it can be the starting point to improve the quality of the service and to compare national and international quality assurance results.
许多文件评估了放射治疗中质量保证的必要性，质量保证必须持续监测并可能加以改进。在这方面，有人提出了一个确认科室质量的系统，并使用质量指标来提高服务质量。国家卫生服务机构（高等卫生研究院）批准了一项提高放射治疗质量的国家研究项目。本研究的目的是分析国家卫生服务研究小组制定的质量指标在一个放射治疗科室中的实际可行性和有效性。
2002年6月至8月，坎迪奥洛的IRCC放射治疗科开展了自愿认证项目。我们根据国家卫生服务项目分析了13项指标中的8项。为此，对在我们科室接受治疗的133例连续患者进行了分析，并根据相应指标（与治疗患者相关的工作人员数量、等候名单、病历准确性、多学科方法、CT执行的治疗计划数量、每次分割的射野数量、每次总体治疗执行的射野影像数量以及患者满意度）报告结果。
与治疗患者数量相关的专业工作人员数量易于计算，可作为进一步评估的基础。总体等待时间为55.4天，因不同的放射治疗目标而有所变化。我们在病历准确性方面达到了80%的符合率。多学科会诊的执行数量在50%至100%之间。每位患者的CT计划数量约为1.6±0.9个计划。每位患者每天的平均射野数量为3.5±1.7个，这与我们中心超过50%的治疗采用适形放射治疗这一事实相符。每例平均进行16.7±10.0次射野影像检查。患者对工作人员的满意度百分比达到了非常高的符合率。
国家卫生服务项目推动的自我评估能够监测服务活动，以评估关键因素，它可以作为提高服务质量以及比较国内和国际质量保证结果的起点。
