Implementation of Web-Based QA Management Platform at Multi-Clinic, Multi-Vendor Institution.
Abstract
Purpose
A web-based quality assurance (QA) management platform can reduce clinic hardware and software needs while streamlining QA workflows through improved accessibility, trend tracking, and automated failure notifications. This study reports on the implementation of such a platform across multi-clinic, multi-vendor environments, highlighting integration challenges and opportunities.
Methods
This study describes the implementation of a web-based QA management platform (SunCheck, Mirion Inc.) across a large metropolitan radiation oncology practice spanning five clinical sites. The deployment encompassed multiple linac platforms (Elekta, Ethos, and TrueBeam/Varian), HDR, and diverse OIS and TPS systems, adding complexity to adoption. To support the transition, a standardization committee aligned current practices with existing machine QA guidelines. Additionally, risk analysis was assessed using failure mode and effects analysis (FMEA) for multiple patient-specific QA (PSQA) methods on the platform.
Results
Our experience suggests that engaging champions within each clinic can facilitate a smoother transition for standardization across multi-clinic environment. The standardization committee proposed a scalable machine QA template based on current guidelines. Our FMEA analysis highlights key PSQA failure modes and supports combining QA strategies to reduce risk. Compared to secondary check only scenario, measurement-based QA improved detection of TPS modeling issues in SBRT and complex plans, reducing FMEA risk-priority numbers from 321 to 210 for errors related to small field delivery and from 155 to 97 for errors related to MLC issues. While all PSQA methods lowered plan deliverability risk scores from 194 to 43.
Conclusion
This report provides perspective of enterprise-wide implementation of a web-based QA management platform in a multi-vendor, multi-clinic environment, and suggests methods to maximize risk reduction. As such, it provides valuable information for other clinics considering a similar transition.