The QuADRANT study: Current status and recommendations for improving uptake and implementation of clinical audit of medical radiological procedures in Europe. The radiotherapy perspective.

Autor: Jornet N; Servei de Radiofísica i Radioprotecció, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; European Society for Radiotherapy and Oncology, Brussels, Belgium. Electronic address: njornet@santpau.cat., Strojan P; Dept. of Radiation Oncology, Institute of Oncology Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia; European Society for Radiotherapy and Oncology, Brussels, Belgium., Howlett DC; Radiology Department, East Sussex Healthcare NHS Trust, Brighton and Sussex Medical School, UK; European Society of Radiology (ESR), Vienna, Austria., Brady AP; Radiology Department, Mercy University Hospital, Cork, Ireland; Radiology Department, University College Cork, Ireland; European Society of Radiology (ESR), Vienna, Austria., Hierath M; European Society of Radiology (ESR), Vienna, Austria., Clark J; European Society of Radiology (ESR), Vienna, Austria., Wadsak W; European Association of Nuclear Medicine, Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria., Giammarile F; European Association of Nuclear Medicine, Vienna, Austria; Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna, Austria., Coffey M; Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland; European Society for Radiotherapy and Oncology, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2023 Sep; Vol. 186, pp. 109772. Date of Electronic Publication: 2023 Jun 28.
DOI: 10.1016/j.radonc.2023.109772
Abstrakt: Background: QuADRANT was a research project funded by the European Commission to evaluate clinical audit uptake and implementation across Europe, with an emphasis on clinical audit as mandated within the BSSD (Basic Safety Standards Directive).
Aim: Focusing on the QuADRANT objectives - to obtain an overview of European clinical audit activity; identify good practices, resources, barriers and challenges; provide guidance and recommendations going forwards; identify the potential for European Union action on quality and safety focusing on the field of radiotherapy.
Results: A pan-European survey, expert interviews and a literature review conducted within the framework of the QuADRANT project indicated that developments in national clinical audit infrastructure are required. While in radiotherapy, there is a strong tradition and high level of experience of dosimetry audits and well-established practice through the IAEA's QUATRO audits, few countries have a well-established comprehensive clinical audit programme or international/national initiatives on tumour specific clinical audits. Even if sparse, the experience from countries with established system of quality audits can be used as role-models for national professional societies to promote clinical audit implementation. However, resource allocation and national prioritisation of clinical audit are needed in many countries. National and international societies should take the initiative to promote and facilitate training and resources (guidelines, experts, courses) for clinical audits. Enablers used to enhance clinical audit participation are not widely employed. Development of hospital accreditation programmes can facilitate clinical audit uptake. An active and formalised role for patients in clinical audit practice and policy development is recommended. Because there is a persisting variation in European awareness of BSSD clinical audit requirements, work is needed to improve dissemination of information on the legislative requirements relating to clinical audit in the BSSD and in relation to inspection processes. The aim is to ensure these include clinical audit and that they encompass all clinics and specialties involved in medical applications using ionising radiation.
Conclusion: QuADRANT provided an overarching view of clinical audit practice in Europe, with all its related aspects. Unfortunately, it showed that the awareness of the BSSD requirements for clinical audit are highly variable. Therefore, there is an urgent need to dedicate efforts towards ensuring that regulatory inspections also incorporate an assessment of clinical audit program(s), affecting all aspects of clinical work and specialties involved in patient exposure to ionising radiation.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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