ArticleJournal of applied clinical medical physics2020
Using failure mode and effects analysis (FMEA) to generate an initial plan check checklist for improved safety in radiation treatment.
Article in Journal of applied clinical medical physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Systematic review of prospective hazard analysis in radiation therapy.Medical physics · 2025Pooled it
- Medical physics practice guideline 4.b: Development, implementation, use and maintenance of safety checklists.Journal of applied clinical medical physics · 2023Guideline
- Use of Large Language Models to Enhance Failure Mode and Effects Analysis: A Case Study.Advances in radiation oncology · 2026Article
- Safety in MR-enhanced daily adaptive SBRT Radiotherapy using a conventional C-arm linear accelerator: An FMEA approach.Zeitschrift fur medizinische Physik · 2025Article
- Development of a hybrid automated chart checking, data collection, and analysis system.Journal of applied clinical medical physics · 2025Article
- Real-time gated proton therapy: Introducing clinical workflow and failure modes and effects analysis (FMEA).Technical innovations & patient support in radiation oncology · 2025Article
- Multicentre prospective risk analysis of a fully automated radiotherapy workflow.Physics and imaging in radiation oncology · 2025Article
- Healthcare Application of Failure Mode and Effect Analysis (FMEA): Is There Room in the Infectious Disease Setting? A Scoping Review.Healthcare (Basel, Switzerland) · 2025Article
- Improving the safety of radiotherapy treatment processes via incident-driven FMEA feedback loops.Journal of applied clinical medical physics · 2024Article
- Enhancing patient safety in radiotherapy: Implementation of a customized electronic checklist for radiation therapists.Technical innovations & patient support in radiation oncology · 2024Article
- Process failure mode and effects analysis for external beam radiotherapy: Introducing a literature-based template and a novel action priority.Zeitschrift fur medizinische Physik · 2024Article
- Multi-phase failure modes and effects analysis for low dose bilateral whole lung irradiation of COVID-19 positive patients requiring respiratory ventilation.Journal of applied clinical medical physics · 2024Article
- ACPSEM position paper: pre-treatment patient specific plan checks and quality assurance in radiation oncology.Physical and engineering sciences in medicine · 2024Article
- Frequency of errors in the transfer of treatment parameters from the treatment planning system to the oncology information system in a multi-vendor environment.Journal of applied clinical medical physics · 2023Article
- Failure modes and effects analysis for surface-guided DIBH breast radiotherapy.Journal of applied clinical medical physics · 2022Article
- Financial and Safety Impact of Simulation-based Clinical Systems Testing on Pediatric Trauma Center Transitions.Pediatric quality & safetyArticle
- Mitigation of Intensity Modulated Radiation Therapy and Stereotactic Body Radiation Therapy Treatment Planning Errors on the Novel RefleXion X1 System Using Failure Mode and Effect Analysis Within Six Sigma Framework.Advances in radiation oncologyArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo apply failure mode and effect analysis (FMEA) to generate an effective and efficient initial physics plan checklist.
methodsA team of physicists, dosimetrists, and therapists was setup to reconstruct the workflow processes involved in the generation of a treatment plan beginning from simulation. The team then identified possible failure modes in each of the processes. For each failure mode, the severity (S), frequency of occurrence (O), and the probability of detection (D) was assigned a value and the risk priority number (RPN) was calculated. The values assigned were based on TG 100. Prior to assigning a value, the team discussed the values in the scoring system to minimize randomness in scoring. A local database of errors was used to help guide the scoring of frequency.
resultsTwenty-seven process steps and 50 possible failure modes were identified starting from simulation to the final approved plan ready for treatment at the machine. Any failure mode that scored an average RPN value of 20 or greater was deemed "eligible" to be placed on the second checklist. In addition, any failure mode with a severity score value of 4 or greater was also considered for inclusion in the checklist. As a by-product of this procedure, safety improvement methods such as automation and standardization of certain processes (e.g., dose constraint checking, check tools), removal of manual transcription of treatment-related information as well as staff education were implemented, although this was not the team's original objective. Prior to the implementation of the new FMEA-based checklist, an in-service for all the second checkers was organized to ensure further standardization of the process.
conclusionThe FMEA proved to be a valuable tool for identifying vulnerabilities in our workflow and processes in generating a treatment plan and subsequently a new, more effective initial plan checklist was created.
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