Evaluating Radiotherapy Infrastructure and Staffing in a Lower-Middle Income Country (LMIC) Setting Using Failure Mode and Effects Analysis (FMEA)
A Yorke1*, E Addison2, S Tagoe3, E Ford4, (1) University of Washington, Seattle, WA, (2) Komfo Anokye Teaching Hospital, ,,(3) Oncology Department, Korle Bu Teaching Hospital, Accra, AA, GH, (4) University of Washington, Seattle, WA
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PO-GePV-T-206 (Sunday, 7/10/2022) [Eastern Time (GMT-4)]
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Purpose: To explore and evaluate the current radiotherapy infrastructure and staffing in the three radiotherapy centers in a LMIC using Failure Mode and Effects Analysis (FMEA). One private and two public institutions.
Methods: FMEA for the current infrastructure and clinic staffing was conducted. The major infrastructure areas identified power outage, internet connection, equipment related issues, number of radiotherapy equipment, treatment planning system and licenses available, technical support from vendor, availability of first aid in treatment room for complicated treatment and patient record keeping. For staffing, the number of radiotherapy staffs, clinical oncologists, medical physicist & treatment planners, radiation therapist (Radiographers), radiation oncology nurses and clinical engineering staff. A risk priority number, RPN, was calculated and used to rank each failure mode. Failure modes with RPN > 100 received recommendation and safety improvement intervention was provided where necessary.
Results: Fourteen failure modes were identified and discussed. The top ranked failure modes had RPN >100 was the number of physicists serving a radiotherapy facility, Limited licenses for treatment planning system and record verify systems, LINAC breakdown and machine downtime, calibration of ion-chamber and electrometers, Co-60 source replacement, project management procedures, medical physics clinical education and training, possibility of administering of dose to the wrong patient, treatment rooms not equipped to handle emergency procedures.
Conclusion: FMEA on the current infrastructure and radiotherapy staffing in a LMIC setting provides an insight to governmental organization and global oncology stakeholders the current state of radiotherapy in practice in less resourced facilities and the ability of radiotherapy staff in these areas to perform with the limited resource and how that can impact the quality of care.
Funding Support, Disclosures, and Conflict of Interest: National Cancer Institute Diversity Supplement Grant 3UH3CA211310-04S1
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