Wright Jean L, Parekh Arti, Rhieu Byung-Han, Miller David, Opris Valentina, Souranis Annette, Choflet Amanda, Viswanathan Akila N, DeWeese Theodore, McNutt Todd, Terezakis Stephanie A
Johns Hopkins University, Department of Radiation Oncology and Molecular Radiation Sciences, 40 North Broadway, Baltimore, MD 21231, USA.
Rep Pract Oncol Radiother. 2019 Jul-Aug;24(4):338-343. doi: 10.1016/j.rpor.2019.05.008. Epub 2019 Jun 1.
We describe a successful implementation of a departmental incident learning system (ILS) across a regionally expanding academic radiation oncology department, dovetailing with a structured integration of the safety and quality program across clinical sites.
Over 6 years between 2011 and 2017, a long-standing departmental ILS was deployed to 4 clinical locations beyond the primary clinical location where it had been established. We queried all events reported to the ILS during this period and analyzed trends in reporting by clinical site. The chi-square test was used to determine whether differences over time in the rate of reporting were statistically significant. We describe a synchronous development of a common safety and quality program over the same period.
There was an overall increase in the number of event reports from each location over the time period from 2011 to 2017. The percentage increase in reported events from the first year of implementation to 2017 was 457% in site 1, 166.7% in site 2, 194.3% in site 3, 1025% in site 4, and 633.3% in site 5, with an overall increase of 677.7%. A statistically significant increase in the rate of reporting was seen from the first year of implementation to 2017 ( < 0.001 for all sites).
We observed significant increases in event reporting over a 6-year period across 5 regional sites within a large academic radiation oncology department, during which time we expanded and enhanced our safety and quality program, including regional integration. Implementing an ILS and structuring a safety and quality program together result in the successful integration of the ILS into existing departmental infrastructure.
我们描述了一个部门事件学习系统(ILS)在一个区域不断扩大的学术性放射肿瘤学部门中的成功实施,该系统与跨临床站点的安全与质量计划的结构化整合相契合。
在2011年至2017年的6年时间里,一个长期存在的部门ILS被部署到了其最初设立的主要临床站点之外的4个临床地点。我们查询了在此期间报告给ILS的所有事件,并分析了各临床站点的报告趋势。采用卡方检验来确定报告率随时间的差异是否具有统计学意义。我们描述了同期一个通用安全与质量计划的同步发展情况。
从2011年到2017年,每个地点的事件报告数量总体呈上升趋势。从实施的第一年到2017年,报告事件的百分比增长在站点1为457%,站点2为166.7%,站点3为194.3%,站点4为1025%,站点5为633.3%,总体增长为677.7%。从实施的第一年到2017年,报告率出现了统计学上的显著增长(所有站点P<0.001)。
我们观察到,在一个大型学术性放射肿瘤学部门的5个区域站点中,事件报告在6年期间显著增加,在此期间我们扩展并加强了我们的安全与质量计划,包括区域整合。实施ILS并构建安全与质量计划共同促成了ILS成功融入现有的部门基础设施。