In this Q&A, Jana Grienke, clinical department administrator, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, shared her experience with using ASTRO’s RO-ILS for incident reporting.
Q: Why did your department decide to use RO-ILS?
A: Our department decided to use RO-ILS to collect patient safety data regarding error rates and error pathways in radiation oncology. We were searching for a mechanism to be able to track these “incidents” to implement improvements based on these events.
Q: How do you use RO-ILS, and what benefits have you seen?
A: We use a generic login so that anyone can report an incident. Our taskforce reviews all incidents on a bi-monthly basis and follows up as needed. The follow-up can be immediate or through our departmental Process Improvement and/or Clinical Team Committees. We use trend analysis to generate quarterly reports.
Benefits we have seen range from: a more open environment of error reporting, using RO-ILS to meet the requirements for Medicare’s Merit-Based Incentive Payment System (MIPS), and learning from other RO-ILS users to see national trends and other opportunities to improve our practice.
Q: How did you get staff to buy in to using RO-ILS?
A: We stressed that this was a non-punitive environment in which we could learn how to improve our processes for the safety of the patient, employees and institution. We also formed a RO-ILS taskforce consisting of a physicist, physician, clinic administrator, chief therapist, head dosimetrist and nurse manager. We believed that having administrative champions was a way for us to achieve buy-in. We also brought the concept to our University Hospital Quality Improvement Team for approval as a tool for patient safety reporting.
Q: What, if anything, has surprised you about using RO-ILS?
A: We prepared extensively for RO-ILS and have used many resources available through ASTRO and AAPM that we haven’t find much surprising—which has been great. However, one interesting thing was to see the nuances in every functional workflow in the department and frankly how everything runs, for the most part, smoothly.
Q: Based on your experience, what recommendations or suggestions would you have for other administrators?
A: Be prepared for people to continue to think this is somewhat of a punitive or finger-pointing tool. We continually struggle with this concept. There can also be reporting fatigue if the same pattern of incidents happen without resolution or improvement. Despite these minor issues, RO-ILS really does aid in cultivating a culture of openness, real-time process improvement and ultimately an enhancement to one’s radiation oncology patient safety environment.