Application of "Trust but Verify" to Major Project Management: Lessons Learned from Massive Clinical Overhauls and Opportunities for Physicists to be Quality Champions Beyond Routine Chart Checks
Abstract
Purpose
The University of Mississippi Medical Center (UMMC) underwent a major clinical transition in 2025-2026, which included Machines: Decommissioned 2 external beam devices and 1 CT simulator Replaced with 2 new external beam devices and 1 new CT simulator Revisions to special procedures: TBI Before: lateral setup After: VMAT TBI on a Bore-Linac SRS Before: Co-60 Teletherapy Device After: C-Arm Linac, micro-MLCs and motion management tools Online Adaptive RT – did not exist in MS prior OIS/TPS Decommissioned 1 Record and Verify (R&V) and 1 Treatment Planning System (TPS) Replaced with 1 new R&V, 2 TPS’s, and 1 New Treatment Management system This abstract is a retrospective to communicate the scope of the clinical overhaul and present lessons learned applicable to the awareness and education of clinical physicists.
Methods
Interdisciplinary feedback on the achievement of milestones and unexpected setbacks in the project.
Results
It is noted that commissioning is ongoing at the time of this abstract deadline, and one installation is not yet complete. A full project retrospective will be possible by Spring 2026. To date, key results include On-time CT commissioning and Linac acceptance Setbacks and missed opportunities for efficiency are more likely where clinical specialists play unfamiliar roles, or are under-involved Clinical department reps can be especially useful in early contracting meetings and ongoing construction checks
Conclusion
The physicist’s role in a high-quality clinic includes clinically related projects, beyond their specialist role in commissioning and clinical workflow QM Clinical teams (i.e. physics, IT) play an important but often informal role in clinical project quality It's never too early to “Trust but Verify” in a major project involving many stakeholders outside of the clinical team. Physicists are natural quality champions not only for routine chart checks, but also largescale project management