Determining the impact of a pre-radiation treatment verification simulation/“dry run” by analyzing intradepartmental reported incidents and surveying staff and patients

Publication date: Available online 21 May 2018
Source:Practical Radiation Oncology
Author(s): Steven Gresswell, Paul Renz, Shaakir Hasan, Margaret Werts, Missy Fortunato, Day Werts
BackgroundError identification in radiation therapy is critical to maintaining a safe and efficient therapeutic environment. A verification simulation, also called a "dry run" for patient information, provides a dedicated time prior to treatment to duplicate steps of patient setup, imaging, and treatment process as a final quality assurance step. Through the use of surveys and analysis of reported incidents, we sought to determine the value of a verification simulation before initiating patient treatment.Methods and Materials.In November 2014, a verification simulation (VS) was instituted across our network of 11 radiation oncology clinics. A comparison of the incident rate reported through our departmental incident learning system (ILS) was made between a non-VS group, comprised of 965 patients treated in the 18-months prior to instituting the verification simulation, and a VS group, consisting of 984 patients treated over 18-months with the verification simulation policy in place. From August–December 2016 surveys were completed by 211 patients and 55 physicians, nurses, and therapists detailing perspectives on the verification simulation.ResultsThere were 28 incidents (2.9%) in the non-VS group compared to 18 incidents (1.8%) in the VS group (p=0.03). In the VS group there were more incidents detected before the day of treatment (P=0.03) and less incidents detected on the day of treatment (P=0.02). Additionally, there was a trend toward fewer incidents reported after treatment started (P=0.09). Patient surveys indicated 99.5% of patients were informed of the verification simulation, 83% reported decreased anxiety during treatment, and 5% indicated concern about delaying treatment. The majority of staff members (67%) were satisfied with the verification simulation.ConclusionA verification simulation helps identify and correct incidents before administration of radiotherapy and reduces patient anxiety.



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