title: Automated survey of 8000 plan checks at eight facilities.
abstract: OBJECTIVE
  To identify policy and system related weaknesses in treatment planning and plan check work-flows.
  
  
  METHODS
  The authors' web deployed plan check automation solution, PlanCheck, which works with all major planning and record and verify systems (demonstrated here for mosaiq only), allows them to compute violation rates for a large number of plan checks across many facilities without requiring the manual data entry involved with incident filings. Workflows and failure modes are heavily influenced by the type of record and verify system used. Rather than tackle multiple record and verify systems at once, the authors restricted the present survey to mosaiq facilities. Violations were investigated by sending inquiries to physicists running the program.
  
  
  RESULTS
  Frequent violations included inadequate tracking in the record and verify system of total and prescription doses. Infrequent violations included incorrect setting of patient orientation in the record and verify system. Peaks in the distribution, over facilities, of violation frequencies pointed to suboptimal policies at some of these facilities. Correspondence with physicists often revealed incomplete knowledge of settings at their facility necessary to perform thorough plan checks.
  
  
  CONCLUSIONS
  The survey leads to the identification of specific and important policy and system deficiencies that include: suboptimal timing of initial plan checks, lack of communication or agreement on conventions surrounding prescription definitions, and lack of automation in the transfer of some parameters.
authors: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114.
authors: Tarek
authors: T
authors: Halabi
authors: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114.
authors: Hsiao-Ming
authors: HM
authors: Lu
authors: Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois 60612.
authors: Damian A
authors: DA
authors: Bernard
authors: Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois 60612.
authors: James C H
authors: JC
authors: Chu
authors: Department of Radiation Oncology, Mass General/North Shore Cancer Center, Danvers, Massachusetts 01923.
authors: Michael C
authors: MC
authors: Kirk
authors: Department of Radiation Oncology, University of Arizona, Tucson, Arizona 85724.
authors: Russell J
authors: RJ
authors: Hamilton
authors: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska 68198.
authors: Yu
authors: Y
authors: Lei
authors: Department of Radiation Oncology, Nebraska Methodist Hospital, Omaha, Nebraska 68114.
authors: Joseph
authors: J
authors: Driewer
mesh_terms: D001331:Automation; D020407:Internet; D011785:Quality Assurance, Health Care; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards*; D011795:Surveys and Questionnaires