Safety culture and incident learning systems in radiation oncology across Australia and New Zealand.
David Thwaites,
United Kingdom
OC-0131
Abstract
Safety culture and incident learning systems in radiation oncology across Australia and New Zealand.
Authors: Laura Adamson1,2, David Thwaites3,4, Rachael Beldham-Collins5, Jonathan Sykes1,2
1Crown Princess Mary Cancer Centre, Radiation Therapy, Sydney, Australia; 2School of Physics, Institute of Medical Physics, University of Sydney, School of Physics, Sydney, Australia; 3School of Physics, Institute of Medical Physics, University of Sydney, School of Physics , Sydney, Australia; 4Crown Princess Mary Cancer Centre , Radiation Therapy, Sydney, Australia; 5Crown Princess Mary Cancer Centre, Radiation Therapy , Sydney, Australia
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Purpose or Objective
Safety
culture (SC) is an essential factor influencing the quality and delivery of
healthcare. Patient pathways are complex in radiation therapy and detailed
quality assurance and incident learning systems (ILS) are used to mitigate
risk. However, errors still occur. This
study aimed to benchmark the knowledge and understanding of SC and ILS in
radiation oncology in Australia and New Zealand (ANZ). It was prompted by the gap
in the literature on these topics for ANZ, with the majority of publications coming
from authors in North America or Europe.
Material and Methods
The Hospital Survey on Patient Safety Culture (1)
was electronically distributed to radiation oncology professionals in ANZ
during 2020; additional ILS-focused supporting questions were included.
Participation was anonymous, with profession and location demographics
collected.
Results
Approximately 5-10% of the radiation oncology workforce in
ANZ responded, with 220 responses analysed. Overall positive safety culture
(SC) was indicated for all ten areas explored, with teamwork showing the
highest rating at 83.7%, followed by local management support (83.3%) and event
reporting (77.1%). The three weakest
areas differed from other studies reported in the literature and were communication about errors (63.9%), hospital-level
management support (60.5%) and handovers and information exchange at interfaces
(58.0%). The results showed different perceptions in the three primary
cohorts: Radiation Oncologists (ROs), Radiation Therapists (RTs) and Radiation
Oncology Medical Physicists (ROMPs). The RO and ROMP cohorts perceived some SC
areas as negative (SC scores <50%). ROs perceived seven of the 10 SC areas
as strong, >75%, with one needing improvement (between 50-75%) and two as
negative. RTs perceived three strong, with the other seven needing improvement;
ROMPs perceived eight needing improvement and two as negative. Most respondents
utilised one or more ILS, with 59% perceiving one or more barriers to
reporting. Variations in ILS utilisation
and definitions were noted.
Conclusion
The findings established
benchmark perspectives of SC and ILS in ANZ. These can be used when departments
investigate their own departmental SC as a comparator. Differences in what and
when to report suggest that more unified definitions at state, federal or
bi-national levels are required and indicate a shared ILS specific to radiation
oncology may eliminate multiple reporting systems and reduce barriers to
reporting. The areas that showed weaknesses in SC highlight areas for further
investigation. Further research into the different perceptions of SC by cohort
is recommended.
1. AHRQ. Surveys on Patient
Safety Culture (SOPS) Hospital Survey Rockville, MD: Agency for Healthcare
Research and Quality 2019 [Available from: https://www.ahrq.gov/sops/surveys/hospital/index.html