S1535
Interdisciplinary - Quality assurance and risk management
ESTRO 2026
Hamburg, Germany. 3 Hospital Pharmacy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Purpose/Objective: Patient safety indicators (PSI) are powerful metrics for assessing the safety of patient care. To date, there is no comprehensive collection of PSI that can be applied to all stages of the radiotherapy process. Within the PaSaGeRO study1 PSIs were developed to serve as a base for a measurement tool for patient safety in
psychometric evaluation, after which PaSaRO may serve as a standardized tool for assessing, monitoring, and improving patient safety in RO. References: 1Baehr A, Christalle E, Grohmann M, Scholl I. Development and psychometric validation of a patient safety assessment tool in German Radiation Oncology: the PaSaGeRO Study protocol. BMJ Open. 2024 Aug 17;14(8):e086214. doi: 10.1136/bmjopen-2024-086214. PMID: 39153790; PMCID: PMC11331847.2Baehr A, Grohmann M, Christalle E, Schwenzer F, Scholl I. Aiming for patient safety indicators in radiation oncology - Results from a systematic literature review as part of the PaSaGeRO study. Radiother Oncol. 2025 Feb;203:110657. doi: 10.1016/j.radonc.2024.110657. Epub 2024 Dec 2. PMID: 39631503. Keywords: Patient Safety Indicators, Quality assurance Digital Poster 3985 Dose prescription and delineation variability based on a national SBRT exercise: The Belgian experience Robbe van den Begin 1 , Stéphanie Smet 2 , Paul Nguyen 3 , Charlotte Billiet 4 , Liv Veldeman 5 , Martijn Swimberghe 6 , Xavier Geets 7 , Melissa Thomas 8 , François Lallemand 9 , Hilde Van Parijs 10 , David Dechambre 7 , Akos Gulyban 1 , Alex De Caluwé 8,1 1 Radiation Oncology, Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, ULB, Brussels, Belgium. 2 Radiation Oncology, AZ Turnhout, Turnhout, Belgium. 3 Radiotherapy, Centre Hospitalier Universitaire UCL Namur, Namur, Belgium. 4 Iridium Netwerk, University of Antwerp, Antwerp, Belgium. 5 Radiotherapy, Ghent University Hospital, Ghent, Belgium. 6 Radiotherapy, AZ Sint-Jan, Bruges, Belgium. 7 Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium. 8 Radiotherapy, AZ Sint-Maarten, Mechelen, Belgium. 9 Radiation Oncology, Centre Hospitalier Universitaire de Liège, Liège, Belgium. 10 Radiation Oncology, AZ Sint- Lucas, Ghent, Belgium Purpose/Objective: To assess interinstitutional differences in fractionation schedules, target contouring, and organ-at-risk (OAR) delineation in stereotactic body radiotherapy (SBRT) for spine and central lung cases across Belgian radiotherapy centres, and to evaluate the feasibility of harmonizing SBRT practice. Material/Methods: Two anonymized clinical cases—a T1 vertebral metastasis and a centrally located lung adenocarcinoma—were distributed to all Belgian RT departments. Participants received identical CT/MRI datasets and a list of structures to delineate:GTV, PTV,
radiation oncology. Material/Methods:
Building on a literature review identifying 145 patient safety indicators (PSIs)2, we determined further PSIs via two focus groups with RO professionals, patient interviews, and expert consultations. Content validity including relevance and comprehensiveness as well as feasibility and verifiability were rated through a 2- phase nationwide Delphi study and comprehensibility through cognitive interviews with RO professionals. RO professionals included physicians, physicists, RTTs, nurses and administrative staff. Experts included physicists with expertise in planning and a hospital pharmacist. Funding: The study is funded by the German Cancer Aid (Deutsche Krebshilfe), grant numbers 70115408 and 70115490. Results: Two focus groups with 14 professionals generated 48 new PSIs, while nine patient interviews contributed 15 PSIs, and three experts suggested 12 more. A total of 213 PSIs were compiled and subsequently rated in the Delphi study by 84 professionals in the first round and 72 in the second. During this process, seven additional PSIs were suggested, and 158 were ultimately deemed relevant with mean agreement rate of 84.92% in round one and 92.66% in round two. Ratings for feasibility and verifiability ranged between 2.0-3.7 2.3- 3.6, respectively, on a 4-point likert-scale. In cognitive interviews, 43 PSIs were linguistically refined to improve clarity. The final collection contains the main categories “human resources”, “institutional culture”, “quality and risk management” and “patient-specific processes”. 27 Subcategories were identified to classify the PSIs further, such as e.g., “Promotion of continuous education and competency review”, “Internal or external peer review procedures”, “Radiation planning and plan evaluation” or “Spatial and temporal organization of patient pathways”. Conclusion: This comprehensive study led to development of 158 consensus-based PSIs. The rigorous multi-method development process ensures strong content validity. Degree of feasibility and verifiability were rated to be rather high. The PSIs will be included in a questionnaire to measure patient safety in radiation oncology (PaSaRO). Future research will conduct
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