Lisbon, Portugal

Comprehensive Quality Management in Radiotherapy – Risk Management and Patient Safety

The course is aimed at radiation oncologists, medical physicists, radiation technologists, (quality/safety) managers and any other health professional interested in risk management and patient safety.


Course directors

  • Brendan McClean, Medical Physicist, St Lukes Radiation Oncology Network, Dublin (IE)
  • Petra Reijnders-Thijssen, Manager Quality & Patient Safety, Maastro, Maastricht (NL)



  • Mary Coffey, Adjunct Associate Professor, Division of Radiation Therapy, Trinity College, Dublin (IE)
  • Nicolas Pourel, Radiation Oncologist, Institut Sainte-Catherine, Avignon (FR)
  • Marcel Stam, Radiation Oncologist, Radiotherapy Group, Arnhem (NL)
  • Aude Vaandering, Radiation Technologist, UCL Cliniques Universitaires St. Luc, Brussels (B

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.

Though accidents are rare and, above all, difficult to prevent, this course aims to identify their precursors. Actively working on these precursors (registration, description, classification), and working on improvements in the radiotherapy process (prevention) is an efficient way to substantially decrease the risk of accidents. In some European countries it is even mandatory to record and report on precursors.


In addition, the course will also discuss preventive analysis that can be done on any radiotherapy process, by trying to identify critical elements that need specific monitoring or quality controls (failure mode analysis). An efficient incident recording system presupposes a good communication both within and sometimes outside the department. Elements of communication are therefore also discussed during the course with a final role-play as an illustration.

Learning outcomes

By the end of this course participants should be able to:

  • Understand the cause, frequency and effects of incidents/accidents in a radiotherapy department
  • Understand the principles of reactive management to incidents (registration, analysis and feed back to the Quality Management System) and of proactive management of safety (incident prevention)
  • Know how to communicate around radiotherapy incidents, with the patient and his/her relatives, within the department itself and with the media.


Course content

  • What is risk? Psychology of making mistakes
  • Ethics for radiation medicine professionals. A just reporting culture
  • Example of the genesis of an accident (take a recent example, relevant to radiotherapy of today)
  • ROSEIS: the precursor in Europe. Frequency of incidents (who reports and what type of incidents are reported)
  • Taxonomy and classification, distinction between incident and accident
  • Analysis and return on experience (root cause analysis)
  •  PRISMA as example (The Netherlands)
  • Benchmarking
  • Bowtie, scenario analyses
  • Health failure mode and effect analysis (HFMEA), a prospective risk management method
  • Practical exercises (hands on)
  • Communication:
    • to the patient
    • to the media
    • to the organisation (departmental, hospital level)
  • Specific training of staff, internal and external (team management)
  • National systems for reporting to regulatory authorities (France)
  • Comprehensive quality management in Radiotherapy Legal aspects of incident reporting
  • Performance indicators.



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

  • 23 hours of lectures
  • 6 hours of practical workshops.


Methods of assessment

Evaluation form

Programme available here

Key words

Patient safety, incident 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.

Ramada by Wyndham Lisbon.
Avenida Eng. Arantes Oliveira nº 9


Lisbon Portugal


Contact the project manager for the hotel booking form.


ESTRO members can order products at substantially reduced prices. To benefit from the member registration rate, you must subscribe for the ESTRO membership 2022 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 2022 are eligible (please make sure your 2022 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).