The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers: Quality Management and Improvement includes discussions about lean thinking, process control, and access to services. Patient Safety and Managing Error looks at reactive and prospective error management techniques. Methods to Assure and Improve Quality deals broadly with techniques to monitor, assure, and improve quality. People and Quality focuses on human factors, changing roles, staffing, and training. Quality Assurance in Radiotherapy addresses the general issues of quality assurance with descriptions of the key systems used to plan and treat patients and includes specific recommendations on the types and frequencies of certain tests. Quality Control: Equipment and Quality Control: Patient-Specific provides explicit details of quality control relating to equipment and patient-specific issues. Recently, a transformation of quality and safety in radiotherapy has begun to take place. Among the key drivers of this transformation have been new industrial and systems engineering approaches that have come to the forefront in recent years following revelations of system failures. This book provides an approach to quality that is long needed, one that deals with both human and technical aspects that must be the part of any overall quality improvement program.

The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers:

• Quality Management and Improvement includes discussions about lean thinking, process control, and access to services.
• Patient Safety and Managing Error looks at reactive and prospective error management techniques.
• Methods to Assure and Improve Quality deals broadly with techniques to monitor, assure, and improve quality.
• People and Quality focuses on human factors, changing roles, staffing, and training.
• Quality Assurance in Radiotherapy addresses the general issues of quality assurance with descriptions of the key systems used to plan and treat patients and includes specific recommendations on the types and frequencies of certain tests.
• Quality Control: Equipment and Quality Control: Patient-Specific provides explicit details of quality control relating to equipment and patient-specific issues.

Recently, a transformation of quality and safety in radiotherapy has begun to take place. Among the key drivers of this transformation have been new industrial and systems engineering approaches that have come to the forefront in recent years following revelations of system failures. This book provides an approach to quality that is long needed, one that deals with both human and technical aspects that must be the part of any overall quality improvement program.

This book was developed for the AAPM 2013 Summer School Proceedings in Colorado Springs, Colorado. Radiotherapy physics has had a very long history of performing quality assurance. Physicists working with the very earliest radiotherapy units developed before the beginning of the last century realized the need to verify the calibration and proper operation of their equipment. The International Commission on Radiation Units and Measurements and the National Council on Radiation Protection and Measurement initiated standardization of quality assurance protocols through a series of recommendations. This was followed by a large collection of professional guidance documents, particularly from the American Association of Physicists in Medicine (AAPM). Through these efforts, radiotherapy became one of the first medical disciplines to establish standardized quality assurance. In light of the increasing complexity of radiotherapy treatments and technology and the diversity of methods used by facilities for various clinical procedures, it is no longer practical to rely solely on generic, prescriptive lists of comprehensive quality assurance (QA) steps to ensure quality and safety for patients. This was the conclusion that guided the AAPM's Task Group 100 away from writing such guidelines for intensity-modulated radiotherapy and toward the examination of quality and safety techniques that have proven so effective first in industry and, more recently, in many medical disciplines. These techniques consider not only QA for equipment, but also for procedures as a whole in the context of the facility. These approaches and methodologies may be new and somewhat daunting to many practicing medical physicists. The goal of this book is to make these new techniques accessible to the broader medical physics community. The CD included in this book contains large tables, figures, and many of the text's images in color.