Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Pract Radiat Oncol. 2013 Oct-Dec;3(4):e165-70. doi: 10.1016/j.prro.2012.12.001. Epub 2013 Jan 15.
Better understanding of the error reporting culture in radiation oncology treatment facilities, and obstacles to reporting, can provide insight into potential areas for improvement. We conducted a survey of radiation therapists and dosimetrists to examine the error reporting cultures in radiation oncology facilities across the United States and staff comfort in reporting errors.
In 2011, a national sample of 1500 radiation therapists and 528 dosimetrists was mailed a 27-item survey assessing perceptions regarding communication among staff, comfort in error reporting, and associated obstacles. Survey results were summarized using descriptive statistics, and factors associated with discomfort with error reporting analyzed using multivariate logistic regression.
A total of 356 radiation therapists from 47 states (24% response rate) and 190 dosimetrists from 35 states (36% response rate) responded to the survey. Almost all (87% of therapists and 88% of dosimetrists) reported that there is an error reporting system in their treatment facility. Most feel that communication between them and physicians and dosimetrists or physicists (81% and 88% of therapists, and 89% and 88% of dosimetrists, respectively) is good, but only 65% of therapists and 66% of dosimetrists agree that communication with administrators is good. Obstacles to reporting errors included hierarchy within the treatment facility, poor communication, and fear of reprimand. On multivariate analysis, previous personal reprimand for reporting errors (odds ratio, 4.13, P = .001) and reprimand of other therapists and dosimetrists (odds ratio, 2.55, P = .03) were significantly associated with discomfort in error reporting.
The majority of therapists and dosimetrists feel communication in their treatment facilities is good and that there are systems in place to report errors. A sizable minority reported experience with reprimand for error reporting that significantly reduced their comfort level with reporting errors. Obstacles identified in this study represent opportunities for future research and potential ways for improvement in radiation oncology treatment facilities.
更好地了解放射肿瘤治疗设施中的错误报告文化以及报告障碍，可以深入了解潜在的改进领域。我们对放射治疗师和剂量师进行了调查，以检查美国各地放射肿瘤治疗设施的错误报告文化以及员工报告错误的舒适度。
2011 年，我们向 1500 名放射治疗师和 528 名剂量师邮寄了一份 27 项的调查问卷，评估了他们对员工之间的沟通、报告错误的舒适度以及相关障碍的看法。使用描述性统计方法总结调查结果，并使用多变量逻辑回归分析与报告错误的不适相关的因素。
共有来自 47 个州的 356 名放射治疗师（24%的回复率）和来自 35 个州的 190 名剂量师（36%的回复率）对调查做出了回应。几乎所有人（87%的治疗师和 88%的剂量师）报告说，他们的治疗设施有一个错误报告系统。大多数人认为他们与医生、剂量师或物理学家之间的沟通良好（81%和 88%的治疗师，89%和 88%的剂量师），但只有 65%的治疗师和 66%的剂量师认为与管理人员的沟通良好。报告错误的障碍包括治疗设施内的等级制度、沟通不畅和害怕受到谴责。在多变量分析中，之前因报告错误而受到个人谴责（比值比，4.13，P=0.001）和对其他治疗师和剂量师的谴责（比值比，2.55，P=0.03）与报告错误的不适显著相关。
大多数治疗师和剂量师认为他们治疗设施中的沟通良好，并且有报告错误的系统。相当一部分人报告说因报告错误而受到谴责，这显著降低了他们报告错误的舒适度。本研究中确定的障碍代表了未来研究的机会和放射肿瘤治疗设施改进的潜在途径。
