Crouch Krystle, Adamson Laura, Beldham-Collins Rachael, Sykes Jonathan, Thwaites David
Sydney West Radiation Oncology Network, Sydney, Australia.
Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia.
J Med Radiat Sci. 2025 Mar;72(1):63-73. doi: 10.1002/jmrs.823. Epub 2024 Sep 15.
Safety and quality improvement are essential to clinical practice in radiation therapy as planning and treatment increase in complexity and sophistication. An incident learning system (ILS) is a safety and quality improvement tool that can aid risk mitigation to improve patient safety and quality of care. The aim of this study was to quantify the impact of implementing a new e-ILS, Learning In Radiation ONcology (LIRON), on reporting and safety culture within a local health district (LHD).
The ILS (LIRON) was implemented in 2020 with the intent of tracking actual incidents, near misses and procedural non-compliances for analysis of root causes and contributing factors. A survey was conducted after 12 months of LIRON use, and distributed to radiation oncologists, radiation therapists and radiation oncology medical physicists within the LHD. Results were compared with the responses to a pre-ILS implementation survey, to review changes in staff perceptions of safety culture, barriers to reporting and ILS understanding.
Survey response rates were similar at baseline and at the 12-month follow-up, 64% and 63%, respectively. Findings showed increased ILS participation (49-71%), increased perception of no barriers to reporting (34-43%) and increased encouragement to report (37-43%). Greater confidence in the department's ability to learn from the ILS was evident (24-46%).
Initial findings of LIRON implementation show positive impact but warrant further long-term review for greater understanding of its impact on staff perceptions, safety culture and improving departmental processes.
随着放射治疗计划和治疗的复杂性及精密性不断提高，安全与质量改进对于放射治疗临床实践至关重要。事件学习系统（ILS）是一种安全与质量改进工具，有助于降低风险，提高患者安全和护理质量。本研究旨在量化实施新的电子事件学习系统“放射肿瘤学学习”（LIRON）对当地卫生区（LHD）内报告情况和安全文化的影响。
ILS（LIRON）于2020年实施，旨在跟踪实际事件、未遂事件和程序违规情况，以分析根本原因和促成因素。在使用LIRON 12个月后进行了一项调查，并分发给LHD内的放射肿瘤学家、放射治疗师和放射肿瘤医学物理学家。将结果与ILS实施前调查的回复进行比较，以审查工作人员对安全文化、报告障碍和ILS理解的看法变化。
基线和12个月随访时的调查回复率相似，分别为64%和63%。结果显示，ILS参与度增加（49%-71%），认为报告无障碍的比例增加（34%-43%），鼓励报告的比例增加（37%-43%）。对部门从ILS中学习能力的信心明显增强（24%-46%）。
LIRON实施的初步结果显示出积极影响，但需要进一步进行长期审查，以更深入了解其对工作人员看法、安全文化和改进部门流程的影响。
