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Title: Does Compliance to Patient Safety Tasks Improve and Sustain when Radiotherapy Treatment Processes are Standardized?
Authors: SIMONS, Pascale 
Houben, Ruud
Benders, Jos
Pijls-Johannesma, Madelon
VANDIJCK, Dominique 
Backes, Huub
Groothuis, Siebren
Issue Date: 2014
Source: European Journal of Oncology Nursing (Online), 18(5), p. 459-465
Abstract: Purpose To realize safe radiotherapy treatment, processes must be stabilized. Standard operating procedures (SOP’s) were expected to stabilize the treatment process and perceived task importance would increase sustainability in compliance. This paper presents the effects on compliance to safety related tasks of a process redesign based on lean principles. Method Compliance to patient safety tasks was measured by video recording of actual radiation treatment, before (T0), directly after (T1) and 1.5 years after (T2) a process redesign. Additionally, technologists were surveyed on perceived task importance and reported incidents were collected for three half-year periods between 2007 and 2009. Results Compliance to four out of eleven tasks increased at T1, of which improvements on three sustained (T2). Perceived importance of tasks strongly correlated (0.82) to compliance rates at T2. The two tasks, perceived as least important, presented low base-line compliance, improved (T1), but relapsed at T2. The reported near misses (patient-level not reached) on accelerators increased (P<0.001) from 144 (2007) to 535 (2009), while the reported misses (patient-level reached) remained constant. Conclusions Compliance increased after introducing SOP’s and improvements sustained after 1.5 years, indicating increased stability. Perceived importance of tasks correlated positively to compliance and sustainability. Raising the perception of task importance is thus crucial to increase compliance. The redesign resulted in increased willingness to report incidents, creating opportunities for patient safety improvement in radiotherapy treatment.
Notes: Simons, PAM (reprint author), Hasselt Univ, Fac Business Econ, Martelarenlaan 42, B-3500 Hasselt, Belgium.;;;;;;;
Keywords: compliance; lean management; standard operating procedures; incident reporting; task importance; patient safety
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ISSN: 1532-2122
DOI: 10.1016/j.ejon.2014.05.003
ISI #: 000343363400003
Rights: © 2014 Elsevier Ltd. All rights reserved.
Category: A1
Type: Journal Contribution
Validations: ecoom 2015
Appears in Collections:Research publications

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