Department of Radiation Oncology, Sydney West Radiation Oncology Network, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.
Department of Radiation Oncology, Sydney West Radiation Oncology Network, Blacktown Cancer & Haematology Centre, Sydney, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2022 Mar;66(2):299-309. doi: 10.1111/1754-9485.13335.
Radiation therapy has a highly complex pathway and uses detailed quality assurance protocols and incident learning systems (ILSs) to mitigate risk; however, errors can still occur. The safety culture (SC) in a department influences its commitment and effectiveness in maintaining patient safety.
Perceptions of SC and knowledge and understanding of ILSs and their use were evaluated for radiation oncology staff across Australia and New Zealand (ANZ). A validated healthcare survey tool (the Hospital Survey on Patient Safety Culture) was used, with additional specialty-focussed supporting questions. A total of 220 radiation oncologists, radiation therapists and radiation oncology medical physicists participated.
An overall positive SC was indicated, with strength in teamwork (83.7%), supervisor/manager/leader support (83.3%) and reporting events (77.1%). The weakest areas related to communication about error (63.9%), hospital-level management support (60.5%) and handovers and information exchange (58.0%). Barriers to ILS use included 'it takes too long' and that many respondents must use multiple reporting systems, including mandatory hospital-level systems. These are generally not optimal for specific radiation oncology needs. Varied understanding was indicated of what and when to report.
The findings report the ANZ perspective on ILS and SC, highlighting weaknesses, barriers and areas for further investigation. Differences observed in some areas suggest that a unified state, national or bi-national ILS specific to radiation oncology might eliminate multiple reporting systems and reduce reporting time. It could also provide more consistent and robust approaches to incident reporting, information sharing and analysis.
放射治疗具有高度复杂的途径，并采用详细的质量保证协议和事件学习系统（ILS）来降低风险；然而，错误仍然可能发生。部门的安全文化（SC）影响其维护患者安全的承诺和有效性。
对澳大利亚和新西兰（ANZ）的放射肿瘤学工作人员的 SC 感知以及对 ILS 及其使用的知识和理解进行了评估。使用了经过验证的医疗保健调查工具（患者安全文化医院调查），并增加了专业重点支持问题。共有 220 名放射肿瘤学家、放射治疗师和放射肿瘤医学物理学家参与。
总体上呈现出积极的 SC，团队合作（83.7%）、主管/经理/领导支持（83.3%）和报告事件（77.1%）较强。沟通错误（63.9%）、医院级管理支持（60.5%）和交接和信息交换（58.0%）等方面较弱。ILS 使用的障碍包括“耗时太长”和许多受访者必须使用多个报告系统，包括强制性的医院级系统。这些系统通常不适用于特定的放射肿瘤学需求。对要报告什么和何时报告的理解存在差异。
研究结果报告了 ANZ 对 ILS 和 SC 的看法，突出了弱点、障碍和进一步调查的领域。在某些领域观察到的差异表明，针对放射肿瘤学的统一的州、国家或双边 ILS 可能会消除多个报告系统并减少报告时间。它还可以为事件报告、信息共享和分析提供更一致和强大的方法。
