BLUE RIBBON POSTER THERAPY: Advancing Radiotherapy Quality through an Adaptive Multicenter Clinical Audit Framework
Abstract
Purpose
To enhance radiotherapy quality and safety through a structured, peer to peer clinical audit initiative conducted at a regional level, aiming to establish a scalable national framework. The project integrates multidisciplinary on site clinical audits, dosimetry audits and collection of quality indicators, supported by structured training and continuous audit methodological improvement.
Methods
This framework comprises three complementary components: 1. Multidiscipinary 4 day on-site clinical audit conducted by three auditors (Radiation Oncologist, Medical Physicist and RTT), following IAEA-QUATRO methodology. 2. Dosimetry audit, undergoing final validation, including an end-to end prostate case using an antropomorphic phantom and review of two shared clinical cases (prescription, delineation and planning). 3. Collection of prostate-specific quality indicators to support center benchmarking. All audited standards are recorded in a REDCap data base, with compliance graded as compliant, partially compliant, or non compliant. Recommendations are categorized by priority (high, medium, low). Audited departments stratify recommendations by implementation difficulty (easy, medium, difficult) to facilitate actionability. A 4-day course on audit methodology was delivered to auditors in training and auditees. Auditors also received training in soft skills and participated as observers in one of the first three audits conducted by international experts. After each audit, a structured satisfaction survey and a debriefing session was conducted.
Results
Two of the three training audits have been completed . In the first audit , 32 recommendations were generated (10 high, 16 medium, 6 low priority). Debriefing feedback led to workflow improvements, including pre-audit virtual meetings to align expectations and dfine agendas, enhancing preparedness, transparency and stakeholder engagement.
Conclusion
This structured and adaptive audit model produces prioritized, actionable recommendations and incorporates continous learning via surveys and debriefings. While early in implementation, the approach provides a strong foundation for sustainability and shows promising potential for broader scalability.