Production, review, and impact of technical quality control guidelines in a national context

Abstract

A close partnership between the Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist's (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) has resulted in the development of a suite of Technical Quality Control (TQC) guidelines for radiation treatment equipment; they outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. The adopted framework for the development and maintenance of the TQCs ensures the guidelines incorporate input from the medical physics com-munity during development, measures the workload required to perform the QC tests outlined in each TQC, and remain relevant (i.e., "living documents") through subsequent planned reviews and updates. The framework includes consolidation of existing guidelines and/or literature by expert reviewers, structured stages of public review, external field-testing, and ratification by COMP. This TQC develop-ment framework is a cross-country initiative that allows for rapid development of robust, community-driven living guideline documents that are owned by the com-munity and reviewed to keep relevant in a rapidly evolving technical environment. Community engagement and uptake survey data shows 70% of Canadian centers are part of this process and that the data in the guideline documents reflect, and are influencing, the way Canadian radiation treatment centers run their technical quality control programs. For a medium-sized center comprising six linear accelerators and a comprehensive brachytherapy program, we evaluate the physics workload to 1.5 full-time equivalent physicists per year to complete all QC tests listed in this suite.

Figure 1

Revision cycles of the Technical Quality Control document review process.

Figure 2

Technical Quality Control document cumulative webpage hits September 2014 to August 2015.

Figure 3

Canadian map showing all radiotherapy centers. Red and Pink markers represent large and small external validation centers, respectively. Green markers represent centers where expert reviewers are employed. White makers indicate centers that have yet to contribute.

Figure 4

Percentage of respondents who made changes to their QA program following publication of the given TQC guideline. Respondents that did not possess the respective equipment were removed from the denominator.