MO‐B‐116‐01: Strategies for Total Quality
Authors: Hancock S , Brown D 
Published: July 2013

This presentation takes a broad view of the meaning of quality in radiation therapy, with a focus on the role of the physicist in the pursuit of quality. The strategic approaches to the pursuit of total quality in radiation therapy draw from the fields of philosophy, industrial engineering, behavioral science, mathematical biology, and neuroscience.

The first presentation covers the following strategies...

• Tools, not rules _ The added cost of the tools of today is justified through efficiencies that can be gained.

• Delegate _ Delegation of QA tasks increases the value of both the physicist and the delegate employees.

• The Situational Leadership model is presented as a guide to effective delegation.

Processes design and improvement QC of equipment performance is not enough if people are not following effective processes

• Create a culture of Total Quality Management Provide leadership and get started with Root Cause Analysis.

• Experience Design _ The experience of the patient should be included in measures of quality

• The Opportunity, Influence, Impact cycle _ You need opportunities for awareness and influence.

• Customer and supplier feedback _ Equipment suppliers should be included in your quality improvement system.

• Organizational strategies _ It is important to have the right reporting relationship between the physicist and management, and the physicist and dosimetrists.

• Influencing staff without direct authority using the Systems Theory model.

• Medical physicist archetypes from 20th Twentieth century American mythology _ Be the town marshal, not the Lone Ranger. The second presentation introduces more advanced strategies for quality improvement, including...

• Implementing an incident and near_miss reporting system.

• Those who cannot remember the past are condemned to repeat it. CG. Santayanaj

• Implementation of an Incident Learning System is a daunting task, but there is tremendous value in even sub_optimal implementations.

• Incident learning systems on a shoe_string budget accessible strategies for implementation and monitoring.

• An abbreviated Failure Modes and Effects Analysis.

• When change is upon us, the FMEA provides a fast, inexpensive, and effective means of getting all the clinical players on the same page for a harmonized clinical practice.

• Finding potential problems before they occur in the clinic.

• Developing an efficient QA process.

Learning Objectives:

1. Define the broad meaning of quality in the context of Total Quality Management, and the application of it in radiation therapy.

2. Describe the role of the physicist in the assurance of quality in radiation therapy.

3. Demonstrate an understanding of 10 strategies for achieving quality.

4. Demonstrate understanding of the formation and persistence of organizational culture.

5. Demonstrate understanding of basic principles of Total Quality Management.

6. Describe the steps of Root Cause Analysis.

7. Describe how to implement an error and near‐miss reporting system.

8. Describe the performance of an abbreviated Failure Modes and Effects Analysis.

9. Demonstrate understanding of the application of experience design to health care.

10. Describe how to influence staff without direct authority using the Systems Theory model.