Granada, Spain

Comprehensive Quality Management in Radiotherapy: Quality Assessment and Improvement

Good quality is impossible to attain if quality standards are not embedded in the culture of the department/institution. Therefore, all staff contributing to the treatment chain are encouraged to attend. Obviously without a heavy involvement of team leaders a quality system will be difficult to set up and to maintain, consequently, all heads of departments and future leaders - should ideally be familiar with what this course will cover.

For the above reasons, the course is aimed at radiation oncologists, medical physicists, radiation therapists (RTTs) and hospital/department administrators. It is also of interest to any team member who might have embarked on a teaching programme with the aim of becoming head of department.

Course directors

  • NĂºria Jornet, Medical Physicist, Hospital de la Santa Creu i Sant Pau (ES)
  • Nicolas Pourel, Radiation Oncologist, Institut Sainte Catherine (FR)


  • Ajay Aggarwal, Clinical Oncologist, London School of Hygiene & Tropical Medicine, London (UK)
  • Savino Cilla, Medical Physicist, Gemelli Molise Hospital, Campobasso (IT)
  • Coen Hurkmans, Medical Physicist, Catharina Ziekenhuis (NL)
  • Amanda Caissie, Radiation Oncologist, Saint John Regional Hospital (CA)
  • Marjolein van Os, Erasmus Medical Center Rotterdam Daniel den Hoed Cancer Center (NL)




This course is part of a two-year cycle on quality management in radiotherapy, consisting of two complementary modules:

  • Risk management and patient safety
  • Quality improvement and indicators.

Industrial and medical activities expose operators, patients and the general public to the risk of accidents that cause corporeal or environmental damage (or both). Harm to operators is very uncommon in radiotherapy, but harm to patients does happen and has had considerable press coverage in many European countries. These widely publicised accidents have focused the attention of both the radiotherapy community and the regulatory authorities on the appropriate preventive actions that could be taken to avoid their repetition.

Fortunately, accidents that actually result in harm to patients are rare. Conversely, small irregularities in the radiotherapy process are very frequent, many hundreds per year in every department. A key to the understanding of the genesis of accidents is the fact that these small irregularities (called precursors), as benign as they seem to be when considered in isolation, can mesh together to result in a fully developed accident. An accident is not the result of very uncommon irregularities; it is the coincidence of very common irregularities that unfortunately occur at a given point in time.

This course aims to:

  • Deliver a comprehensive overview of how to set up a quality system in a department, define useful quality indicators and learn different methods to monitor and improve quality
  • Provide awareness of what clinical audits and clinical trials can contribute to a quality system
  • Introduce techniques for technology assessment and algorithms to calculate staffing levels in a department, topics of outmost importance in this time of financial crisis.

Learning Outcomes

By the end of this course participants should be able to set up or review the quality system in their department.

In particular they should be able to:

  • Explain how risk management, quality monitoring and quality improvement are linked
  • Construct a process chart from the different steps in the treatment
  • Define quality indicators and quality standards
  • Compare tools and methods to monitor quality, application to radiotherapy
  • Apply LEAN method for quality improvement
  • Explain how clinical audits are set up and how they contribute to quality assessment and improvement
  • List different methods for technology assessment
  • Perform staffing levels calculations.

Course Content

Lectures will be held in the morning followed by practical cases and discussion in the afternoon. We aim to allow the participants to put to practice what will have been discussed during the morning lectures and to learn how to work in a multidisciplinary and international group. 

  • From risk management to quality improvement: how can we use the information that we get from FMEA, fault tree analysis, etc. to feed our QI system?
  • Quality assessment:

- metrics for quality measurement: quality indicators

- quality standards

- monitoring quality indicators (general)

- how to interpret quality measures

- monitoring quality indicators through SPC

- how should tolerance and action levels be set?

  • Methods for quality improvement:

- introduction to different methods

- a focus on LEAN

  • Quality improvement strategies: clinical audits and feedback
  • Technology assessment methods:

- cost-effectiveness studies: HERO project

- QA in clinical trials

  • Staffing levels in RT
  • European directives on quality and safety in radiotherapy.


The two courses on Quality Management, Risk Management and Quality Assessment, have been designed to be complementary and it is recommended to attend both to get a complete picture of quality management. However, the order in which they are taken does not matter. To fully profit from the course it is recommended that participants have at least three years’ experience in a radiation oncology or medical physics department to have a complete picture of the radiotherapy process.

Teaching Methods

  • 12 hours of lectures
  • 5 hours of practical workshops
  • 3 hours of case discussions.

Methods of Assessment

  • Evaluation form
  • MCQ.

Draft programme available here

Key words

Brachytherapy, imaging, segmentation, localisation, dosimetry, treatment planning, TG43, Monte Carlo, grid based Boltzmann equation solver Acuros, collapsed cone ACE, commissioning, optimisation, inverse planning, dose prescription, dose reporting, verification, in vivo, QA, uncertainty, quality management.


Application for CME recognition will be submitted to the European Accreditation Council for Continuing Medical Education (EACCME), an institution of the European Union of Medical Specialists (UEMS). EACCME credits are recognized by the American Medical Association towards the Physician’s Recognition Award (PRA). Information on the status of the applications can be obtained from the ESTRO office.

Application for CDP credits has been submitted to the European Board for Accreditation in Medical Physics (EBAMP). Information on the status of the application can be obtained from the ESTRO office.

Grand Hotel Luna de Granada

Plaza del Guitarrista Manuel Cano, 2

18004 Granada



ESTRO members can order products at substantially reduced prices. To benefit from the member registration rate, you must subscribe for the ESTRO membership 2023 BEFORE registering to the course. To become an ESTRO member, benefit from the member registration rate and discover the many other member advantages, please visit the membership page.



Early rate

Late rate


  750 EUR

 850 EUR

ESTRO Members

  600 EUR 

 725 EUR

In-training members*

  450 EUR

 625 EUR

* Members with specialty RadiationTherapist (RTT) may register at the In-Training fee

Early rates are applied up to three months before the starting date of the course.

Late rates are applied three months before the starting date of the course.

The fee includes the course material, coffees, lunches, and the social event.

Advance registration & payment are required.

Since the number of participants is limited, late registrants are advised to contact the ESTRO office before payment, to inquire about availability of places. Access to homework and/or course material will become available upon receipt of full payment.

Insurance and cancellation

The organiser does not accept liability for individual medical, travel or personal insurance. Participants are strongly advised to take out their own personal insurance policies.   

In case an unforeseen event would force ESTRO to cancel the meeting, the Society will reimburse the participants fully the registration fees. ESTRO will not be responsible for the refund of travel and accommodation costs.

In case of cancellation, full refund of the registration fee minus 15% for administrative costs may be obtained up to three months before the course and 50% of the fee up to one month before the course. No refund will be made if the cancellation request is postmarked less than one month before the start of the course.

Reduced fees

Members from emerging countries may register at a preferential rate of 350 Euro. Emerging country fee applies to individuals from low-income and lower-middle-income economies according to the World Bank listing here.

Additionally, all specialties from the following countries can benefit from this preferential rate: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Greece, Hungary, Latvia, Lithuania, Macedonia, Moldova, Montenegro, Poland, Portugal, Romania, Russian Federation, Serbia, Slovak Republic, Slovenia, Spain, Turkey, Ukraine.  In addition, medical physicists from Cyprus can email to apply for this fee.

The preferential rate of 350 Euro is granted automatically when you click on the  BOOK NOW  button and the three conditions below are met:

  1. Only ESTRO members for 2023 are eligible (please make sure your 2023 membership is in order before you click on the BOOK NOW  button)
  2. Only one course per person per year can be subsidized by ESTRO
  3. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  

 Please note:

  • We can only guarantee a certain number of reduced fees per course
  • Application deadlines are the same as early registration fees (3 months before the course date).