Author: Shahid B. Awan, Harold Li, Aba Lippuner 👨🔬
Affiliation: Department of Radiation Oncology, University of Kansas Medical Center 🌍
Purpose: QA review is a necessary component of QA management but is often pushed aside owing to time constraints and overreliance on vendor solutions. At our multicenter institution, we designed a 3-step cost-effective solution to automatically review QA. The workflow provides a blueprint for any-sized institution to follow.
Methods: Using monthly LINAC QA as a working example, we first standardized our QA workflow (step 1) for one main (4 LINACS) and 5 satellite sites (6 LINACs). A dedicated monthly QA meeting was essential for this process. A single automated QA form/spreadsheet was subsequently created. This VBA macro-enabled, color-coded, and instruction filled form, was designed to automatically populate with data unique to the selected machine.
Results: Standardization thus enabled automation (step 2) --creation of a system that could automatically log, trend, review, and follow up on user data. VBA macros enabled automatic QA review by presenting errors for the user to review before capturing the data for recording and trending, searching missing documents, comparing machine baselines, sending periodic email reminders of upcoming electrometer/chamber calibration, to name a few. A continuing monthly QA meeting (step 3) with essential subcommittees naturally offered a platform to voice ideas for troubleshooting, highlighted machine issues which might impact clinical decisions, and further encouraged ideas for workflow optimization such as hard-coding certain user selections to prevent recurrent user errors. Our setup inspired the design of Python scripts for automated QA analysis, a standardized QA template in Eclipse, and more macros to automatically generate standardized folders and a final report.
Conclusion: Using these three steps in the design of any QA template leads to a robust QA review program. This is useful for any sized institution and improves ease of cross coverage, accuracy of forms, instruction of residents, communication within the clinic and autonomy in data handling.