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

Abstract Purpose Error identification in radiation therapy is critical to maintain a safe and efficient therapeutic environment. A verification simulation (VS; 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 VS before initiating patient treatment. Methods and materials In November 2014, a 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 (965 patients who were treated in the 18 months prior to instituting the VS) and a VS group (984 patients who were treated over 18 months with the VS policy in place). From August to December 2016, surveys were completed by 211 patients and 55 physicians, nurses, and therapists detailing their perspectives on the VS. Results There were 28 incidents (2.9%) in the non-VS group compared with 18 incidents (1.8%) in the VS group ( P = .03). In the VS group, more incidents were detected before the day of treatment ( P = .03) and fewer incidents on the day of treatment ( P = .02). In addition, a trend toward fewer incidents after treatment started ( P = .09) was observed. Patient surveys indicated that 99.5% of patients were informed of the VS, 83% reported decreased anxiety during treatment, and 5% indicated concerns about delaying treatment. The majority of staff members (67%) were satisfied with the VS. Conclusions A VS helps identify and correct incidents before the administration of radiation therapy and reduces patient anxiety.