PV QA 3 - Poster Viewing Q&A 3
TU_28_3086 - Morbidity and Mortality Review Meetings Procedure for Radiation Therapy Departments as Part of a Quality Governance Program and Organization: The French "Proust" Survey
Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3
Yazid Belkacemi, MD, PhD
Henri Mondor Univsrsity Hospital and Faculte de Medecin de Creteil Paris XII
University Paris Est Creteil and H Mondor Hospital: MD PHD: Employee
Morbidity and Mortality Review Meetings Procedure for Radiation Therapy Departments as Part of a Quality Governance Program and Organization: The French “Proust” Survey
Y. Belkacemi1, L. Colson-Durand2, M. Fayolle-Campana3, N. H. To4, A. Rialland5, S. Bastuji-Garin5, A. Jouhaud1, M. L. Herve1, L. Fillard6, D. Lerouge7, F. Jaffre8, M. A. Bollet9, and D. Azria10; 1Department of Radiation Oncology and Henri Mondor Breast Center, Henri Mondor University Hospital, AP-HP, Creteil, France, Creteil, France, 2AP-HP. Department of Radiation Oncology and Henri Mondor Breast Center. University of Paris-Est (UPEC), Creteil, France, 3AP-HP. Department of Radiation Oncology. Henri Mondor University Hospital., Creteil, France, 4AP-HP. Department of Radiation Oncology. Henri Mondor University Hospital. University of Paris-Est (UPEC), Creteil, France, 5Biostatiscs Unit. Henri Mondor Univesity Hospital, Creteil, France, 6Department of Radiation Oncology. Henri Mondor University Hospital., Creteil, France, 7Department of Radiation Oncology. Centre Baclesse, Caen, France, 8Department of Radiation Oncology. HEGP University Hospital., Paris, France, 9Institut de Cancérologie Hartmann, Levallois, France, 10Montpellier Cancer Institute, Montpellier, France
Many hospitals have integrated morbidity and mortality review (MMR) meetings into their governance. MMR meetings in Radiotherapy (RT) departments aim to monitor radiation-induced early and late toxicities and identify potential factors that may be correlated with their development, particularly treatment planning errors. In France systematic MMR is not mandatory in daily practice. The first aim of the PROUST project was to make an inventory of existing MMR meetings in the French RT departments and to describe their procedure when are implanted. We present herein the first results of the PROUST French survey.
The link to the web-questionnaire of the PROUST survey was sent to all RT departments in France, members of the French Society of Radiation Oncology (SFRO) after its validation by the five designed pilot RT centers. The questionnaire included items of organization, frequency, membership, governance, reasons for non-implantation of MMR and interest in its creation.
As of July 2017, we had received 108 responses. One hundred percent of the centers declared that they had initiated a quality assurance program, including implantation of feedback committees (CREx) dedicated to the registration, analysis and correction of precursor events of potential accidents. Less than half the centers (47%) had implanted MMR procedures. Among these, only 47 filed the details on their MMR organization. In addition, there was confusion with CREx in the large majority of them. For 80% of the centers, MMRs were either organized every three years, yearly, or only if needed for a given patient with abnormal toxicity. In the majority of centers no details were given for the delay or for the fact that the MMRs were mixed with CREx without a formal and distinct methodology. MMR were initiated by doctors (97%). In a quarter of the centers (24%), MMR are organized only when new files are presented. MMR organization every 6 and 12 months was observed in 21% and 15% of the centers, respectively. In 60% of the centers, acute and late toxicities >/= grade 3 were the main reasons for the MMR procedure initiation. Additionally, 55% did not implant a MMR procedure because of a lack of time. From a practical point of view, contouring procedures and dosimetry criteria were reviewed by 66% and 83% of centers practicing MMR, respectively. Only 40% enrolled the data in a registry dedicated to the surveillance. In addition, 78% of the centers without MMR procedure expressed an interest in initiating a consensual procedure.
In France, MMR meetings are not systematically organized in the RT departments. Less than half the departments that have quality assurance programs discuss during the CREx toxicity review without a formal procedure. A large majority of the centers are interested in implanting an institutional MMR procedure and register their data in the PROUST project that will include clinical, physical and individual radiosensitivity criteria of patients presenting severe toxicity after RT.
Author Disclosure: Y. Belkacemi: None. L. Colson-Durand: None. M. Fayolle-Campana: None. N. To: None. A. Rialland: None. M. Herve: None. F. Jaffre: None.