General Concepts on QA Program for Teletherapy and HDR David Huang, PhD, DABR Chief, Medical Physics Memorial SloanSloan-Kettering Cancer Center WHY QA PROGRAM 1 ACR Statements Every patient with cancer deserves to receive the best possible management to achieve cure, long-term tumor control or palliation Every patient comes for diagnosis deserves to receive the correct diagnosis with minimum side effect from radiation to get a accurate, earlier detection of disease JCAHO Views JCAHO states: There shall be quality control policies and procedures governing nuclear medicine activities that assure diagnostic and therapeutic reliability and safety of patients and personnel JCAHO requires that QA in radiation field be a part of the hospital’ hospital’s QA program, and more recently, that a program of Continuous Quality Improvement (CQI) be implemented 2 ALARA Principle Radiation equipment is a great device for diagnosis and treatment, however, the nature of radiation may cause radiationinduced side effects to the patients ALARA Principle is an essential guideline for radiation applications Cost-Effectiveness Views Cost effectiveness is also an important issue for radiation medicines under nowadays medical environment To control the exponential growth of imagingimagingrelated expenditures, the US government and third party have implemented “PayPay-forforPerformance (P4P)” (P4P)” ACR held a conference “ P4P: Translating Quality into Economic and Success” Success” to discuss the strategies for implementing quality program including patient safety, interpretation accuracy… accuracy…and more 3 How QA PROGRAM Work Team Work The comprehensive Quality Management program has clinical, clinical, physical, physical, and administrative components and its implementation requires the team work of all personnel The physician, physician, physicist, physicist, and technologist along with other member of the team should collaborate on developing a written QA program for Quality Management program 4 Mechanism The QA program details the quality control tests and procedures, procedures, their frequency, frequency, the action criteria, criteria, the records required and the personnel required to perform them The QA program should have a QA committee and include a feedback mechanism to that committee so that the cause of any shortcomings can be addressed and corrected promptly and properly General Guidelines Periodic check the performance Checked with “qualified” instruments Performed with “qualified” personnel Followed detail procedures Guided by a updated policy manual Followed a report and action channel Run by a comprehensive QA program Aim for goal CQI 5 What Is QA PROGRAM Looking For Issues To Be Addressed Machines function properly? All measurements within the tolerance? All parameters within the specification? Any actions needed to be addressed Meet ALARA criteria? Meet the Federal/State regulation? Meet the clinical standard? Are patients and staffs safe? 6 What Should QA Program Cover? To assure the positive answers to the above questions, the QA program should cover the following major areas: a. Safety b. Mechanical c. Dosimetry d. Image quality 視聽監視器 (Safety) Safety) 7 旋轉臂輻射旋轉中心 (Mechanical) 光子輸出劑量 (光子輸出劑量穩定度) (Dosimetry) Dosimetry) 8 OBI (Image Quality) 9