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Quality Assurance > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

What is the purpose of QA in RT? (4)

A
  • reduces random and systematic errors in all steps of care improving dosimetric and geoetric accurey and precision
  • increases the probability erros are recognised and rectified reduing their consequences for patients
  • allows a reliable inter-comparision of results amount centres
  • high level accuracy and consistency is achieved
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2
Q

What are the steps of care QA is involved in? (7)

A
  1. Diagnosis
  2. Consultation
  3. imagine/simulation
  4. treatment planning
  5. pre-treatment delivery
  6. treatment
  7. follow up
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3
Q

In QA what is the role of the RT?

A
  • demonstrate a thorough knowledge of QA and procedure

- knowledge and application of procedures used in QA and follows department polices and procedures

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4
Q

Why are there so many different QA documents?

A
  • as each Nation/state have their own standards and protocols
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5
Q

Why is it important to understand the national/state standards?

A
  • as what RTs can do legally differs from one country to another e.g. in UK only physicts do QA but in AUS RTs can do daily QA
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6
Q

What is the benefit and downfall of mutli-disciplinary QA?

A
  • repsonsibilites shared decreases workload for each individual
  • clear responsibilities and training need to be provided and any overlaps must be clarrified
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7
Q

What is the rationale for stringent QA?

A
  • address the errors that can be controlled so that the errors that can’t be controlled
    matter less
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8
Q

Define quality assurance

A
  • ioverall process which is supported by QC activities.
  • activities that impose specific quality on a process, such as evaluation of operating performance of a device and comparing it to a desired goal
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9
Q

Define quality system management

A
  • is the management of

a QA program

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10
Q

Define quality control

A
  • mechanism and procedures by which one can assure quality

- these include all the activities that demonstrate a level of quality achieved by the output of a process

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11
Q

QA is concerned with operational techniques and activities used to … (2)

A
  1. check that quality requirements are met.

2. adjust and correct performance if the requirements are found not to have been met

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12
Q

Define QA in the context of RT

A
  • is all procedures that
    ensure consistency of the medical prescription and safe
    fulfillment of that radiotherapy related prescription
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13
Q

What are some examples of medical procedures that need QA? (4)

A
  1. dose to the target volume
  2. Minimal dose to normal tissue.
  3. Adequate patient monitoring aimed at determining the optimum end result of the treatment.
  4. Minimal exposure of personnel
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14
Q

What is the general structure of equipment QA programme? (4)

A
  1. Acceptance Testing and Commissioning
  2. Routine QC checks
  3. Additional QC checks
  4. Planned preventative maintenance (PM) program
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15
Q

What is acceptance testing?

A
  • Acceptance of equipment is the
    process in which the supplier demonstrates the
    baseline performance of the equipment to the
    satisfaction of the customer
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16
Q

What is comissioning?

A
  • Commissioning is the process of
    preparing the equipment for clinical service
  • usually done by physics
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17
Q

When is QC first done?

A
  • begins immediaey after comissioning
18
Q

Why is risk management important?

A
  • It plays a vital role in supporting and
    informing decision making in providing a
    safe and secure environment for patients,
    staff and the public
19
Q

What is the reasoning behind risk management?

A
  • We must be proactive in reducing
    identified risk to an acceptable level with
    preventative measures rather than reactive
    remedies
20
Q

When does preventative maintenance occur?

A
  • after commissioning and before regular QC tests
21
Q

What are the QC program specifications (8)?

A
  • parameteres tested
  • specific equipment to be used
  • geometry of test
  • frequency of tests
  • staff group or individual performing tess responsible for standards
  • expected results
  • tolerance and action levels
  • actions required when the tolernaces are exceeded
22
Q

Who is the main regulatory body for QA?

A
  • ARPANSA
23
Q

What are the services of ARPANSA?

A
  • monitoring
  • testing and calibration
  • training
  • hire radiaiton meters
24
Q

Who conducts dosimetry audits?

A
  • the australian clinical dosimetry service
25
Q

What is Australina Clinical Dosimtry Service?

A
  • a national independent dosimetry auditing program, providing quality assurance for radiation oncology facilities and patients
  • team consists of 2 MP and 2 RT
26
Q

Define Quality audit

A
  • is a systematic and independent test to determine if quality activities and results comply and if these are implemented effectively
27
Q

What is the rationale for quality audits?

A
  • evaluate the need for improvmenet or corrective action is those standards are not met
28
Q

What are the characteristics of a quality audit?

A
  • should be regular and form part of a quality feedback loop to improve quality
  • voluntary or regulatory
  • procedural or practical
29
Q

What is the scope of a quality audit?

A
  • check documentation
  • check meausurements
  • assess infrastructure
30
Q

What is an example of an international quality audit?

A
  • IAEA/WHO TLD audit
  • small TL dosimeters (0.5x2.5cm) are distributed by mail to participants for irradiation and upon their return, they are read in the IAEA dosimetry laboratory
  • criteria TLD results within 5%
31
Q

What is a level 1 ACDS audit?

A
  • occurs every two years
  • mail out
  • independent measurements of Linac output under reference conditions
32
Q

What is a level 1B ACDS audit?

A
  • new linac
  • upon request
  • ACDS staff perform onsite measurements using own dosimetry equipment
  • audit photon and electron dose output, FFF beams and small field beams
33
Q

What is a level 2 ACDS audit?

A
  • once every 4 years
  • diagnostic test of the TPS performance
  • mail out audit
  • independent measurments of linac output under reference conditions
34
Q

What is an example of a level 2 ACDS audit?

A
  • C-shaped target volume adapted to a horseshoe

- test 5 beam types to test the intended dose

35
Q

What is the pass criteria for a level 2 ACDS audit?

A
  • 3DCRT = 5%

- IMRT/FFF = 3%, 3mm

36
Q

What is a level 3 ACDS audit?

A
  • to detemine absorbed dose to water delivered to selected points within n anthropomorphic phantom
  • this is an end-to-end audit where the phantom undergoes all steps within the radiotherapy treatment chain
37
Q

What are 3 level 3 ACDS audits from 3DCRT?

A
  • chair test = 3.3%
  • c-shape test = 3.3-5%
  • complex case = 5%
38
Q

What is the monthly TPS QA check?

A
  • checksums on beam data and executable files
39
Q

What is the rationale for checksum QA?

A
  • the program cannot be modified by the operator therefor it should be verified that it has not been corrupted by any virus or wrong operations
  • the beam data can be modified
40
Q

What are forms of peer review and who attends each meeting?

A
  • physician lead case oriented (RO, RT, physics)
  • tumour board (multiple physicians and people from diverse disciplines)
  • chart rounds (members of treatment team)
  • morbidity and mortality
41
Q

What are the steps for a PRAT peer review?

A
  1. patient selectio
  2. preliminary scoring of each case
  3. peer review meeting to discuss all cases and feed back to RO
  4. subsequent re-audit of al cases where a change in management was discussed

Quality Assurance (5 decks)

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