| General |
| Increase staff training regarding to equipment operation (e.g. RIS, R&V system, TPS, IGRT software and treatment machines, training for using of immobilization devices) Continuous revising of checklist more comprehensibly at each phases Sharing information in MDT morning meeting (e.g. checking tasks not yet been completed, briefing of caution points for first and complex cases) Improving working environment (adding visual monitors in treatment room, manuals and protocols shared with a common holder on RIS, filling cabinet for handling documents such as checklist) Inspection of transferred works at the end of operation CT-S Checking CT reference point coordinates and patient orientation with radiopaque makers put on front and right side of patient ITV not created with only slow-scan technique
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| Treatment planning |
| Increasing initial plan review session by senior RO on especially complex and hypo-fraction cases Bulletin table index for parameters not compatible with treatment machine Logical check of parameters compatible with treatment machine in use of in-house software Protection of final approved plan in TPS Confirming naming policy such as plan ID and approved plans Improving planning method (e.g. contrivance for reducing RT tasks in treatment delivery)
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| Preparation |
| RT independent checking of transferred images correct on IGRT software Prohibiting use of shortcut keys (e.g. avoid unintended action such as field flip on R&V system) Position verification Field shape check on R&V system with beam's eye view after editing couch positions Independent checks of inputted treatment couch position by senior RT
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| Treatment delivery |
| First treatment day attendance of MP or senior RT as checker in especially complex cases Streamlining treatment delivery workflow (e.g. voice confirmation, double check procedure, patient monitoring, inspection of all field delivered) Patient instruction regarding to communication during treatment delivery (e.g. hand gesture) Checking all treatment implemented as inspection of final treatment day
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| On-treatment verification |
| Increase plan review sessions twice in a week Continuous feedback regarding to clinical issue at weekly review session Independent weekly checks of treatment schedules by senor RT and MP
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