The Dancing Cord: Inherent Spinal Cord Motion and Its Effect on Cord Dose in Spine Stereotactic Body Radiation Therapy.

Background: Spinal cord dose limits are critically important for the safe practice of spine stereotactic body radiotherapy (SBRT). However, the effect of inherent spinal cord motion on cord dose in SBRT is unknown.

Objective: To assess the effects of cord motion on spinal cord dose in SBRT.

Durable Improvement in Patient Safety Culture Over 5 Years With Use of High-volume Incident Learning System.

Purpose: Incident learning systems (ILSs) require substantial time and effort to maintain, risking staff burnout and ILS disuse. Herein, we assess the durability of ILS-associated safety culture improvements and ILS engagement at 5 years.

Methods And Materials: A validated survey assessing safety culture was administered to all staff of an academic radiation oncology department before starting ILS and annually thereafter for 5 years.

A ring-based compensator IMRT system optimized for low- and middle-income countries: Design and treatment planning study.

Purpose: We propose a novel compensator-based IMRT system designed to provide a simple, reliable, and cost-effective adjunct technology, with the goal of expanding global access to advanced radiotherapy techniques. The system would employ easily reusable tungsten bead compensators that operate independent of a gantry (e.g.

Interrater reliability of a near-miss risk index for incident learning systems in radiation oncology.

Purpose: Tools for assessing the severity and risk of near-miss events in radiation oncology are few and needed. Recent work has described guidelines for the use of a 5-tier near-miss risk index (NMRI) for the classification of near-miss events. The purpose of this study was to assess the reliability of the NMRI among users in a radiation oncology department.

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system.

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity.

Can emergent treatments result in more severe errors?: An analysis of a large institutional near-miss incident reporting database.

Purpose: Emergent radiation treatments may be subject to more errors because of the compressed time frame. Few data exist on the magnitude of this problem or how to guide safety improvement interventions. The purpose of this study is to examine patterns of near-miss events in emergent treatments using a large institutional incident reporting system.

Metrics of success: Measuring impact of a departmental near-miss incident learning system.

Purpose: There is a growing interest in the application of incident learning systems (ILS) to radiation oncology. The purpose of the present study is to define statistical metrics that may serve as benchmarks for successful operation of an incident learning system.

Methods And Materials: A departmental safety and quality ILS was developed to monitor errors, near-miss events, and process improvement suggestions.

Measurable improvement in patient safety culture: A departmental experience with incident learning.

Purpose: Rigorous use of departmental incident learning is integral to improving patient safety and quality of care. The goal of this study was to quantify the impact of a high-volume, departmental incident learning system on patient safety culture.

Methods And Materials: A prospective, voluntary, electronic incident learning system was implemented in February 2012 with the intent of tracking near-miss/no-harm incidents.