Critical success factors for implementation of an incident learning system in radiation oncology department

Interventions to Promote Safety Culture in Cancer Care: A Systematic Review

OBJECTIVES

There is limited guidance on how to effectively promote safety culture in health care settings. We performed a systematic review to identify interventions to promote safety culture, specifically in oncology settings.

METHODS

Medical Subject Headings and text words for "safety culture" and "cancer care" were combined to conduct structured searches of MEDLINE, EMBASE, CDSR, CINAHL, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science for peer-reviewed articles published from 1999 to 2021. To be included, articles had to evaluate a safety culture intervention in an oncology setting using a randomized or nonrandomized, pre-post (controlled or uncontrolled), interrupted time series, or repeated-measures study design. The review followed PRISMA guidelines; quality of included citations was assessed using the ROBINS-I risk of bias tool.

RESULTS

Eighteen articles meeting the inclusion criteria were retained, reporting on interventions in radiation (14 of 18), medical (3 of 18), or general oncology (1 of 18) settings. Articles most commonly addressed incident learning systems (7 of 18), lean initiatives (4 of 18), or quality improvement programs (3 of 18). Although 72% of studies reported improvement in safety culture, there was substantial heterogeneity in the evaluation approach; rates of reporting of adverse events (9 of 18) or Agency for Healthcare Research and Quality Safety Culture survey results (9 of 18) were the most commonly used metrics. Most of the studies had moderate (28%) or severe (67%) risk of bias.

CONCLUSIONS

Despite a growing evidence base describing interventions to promote safety culture in cancer care, definitive recommendations were difficult to make because of heterogeneity in study designs and outcomes. Implementation of incident learning systems seems to hold most promise.

Utilization of ChatGPT in Medical Education: Applications and Implications for Curriculum Enhancement

Background

The integration of artificial intelligence (AI) into medical education has sparked a paradigm shift in pedagogical approaches, reshaping the way medical knowledge is accessed, processed, and applied. Medical education is a dynamic field that demands continuous adaptation to the evolving healthcare landscape. ChatGPT, an advanced AI language model, with its natural language understanding and generation capabilities, offers a multifaceted toolset that enhances various aspects of medical education.

Objective

The objective of this paper is to explore how ChatGPT, an advanced AI language model, is transforming medical education by serving as a dynamic information resource and driving curriculum reform. It aims to highlight the multifaceted uses of ChatGPT and its potential to reshape the pedagogical landscape in medical education.

Methods

PubMed, Scopus, Web of Science, ERIC, and Google Scholar databases were searched to assess the literature that met the study objectives from 2019 to August 2023 with explicit inclusion and exclusion criteria.

Results

The results demonstrate that ChatGPT's applications in medical education are diverse and encompass real-time curriculum adaptation, personalized learning, and collaborative learning. Its capacity to provide immediate and contextually relevant information has the potential to enhance the quality of medical education significantly.

Conclusion

ChatGPT's integration into medical education represents a transformative shift in educational approaches. It offers a wide range of capabilities, from serving as a repository of medical knowledge to facilitating collaborative learning. As medical education continues to evolve, ChatGPT emerges as a powerful tool that can reshape pedagogy and drive meaningful curriculum reform to meet the needs of modern healthcare practice.ChatGPT emerges as a transformative tool that holds the potential to reshape the landscape of medical pedagogy and drive meaningful curriculum reform.

Electronic On-line Incident Reporting System (IRS) as a Tool for Risk Assessment in Radiation Therapy

Background

Radiotherapy is one of the primary treatment options in cancer management, together with surgery and chemotherapy. Radiation therapy is technologically complex discipline involving professionals with various specialties, and using high energy radiation in treatment of wide range of different cancer types. Technical complexity, increasing number of patients, large workload, and delivery of radiation therapy treatment with lack of human, technical and financial resources in low and middle income countries creates environment with great potential to develop incidents. Emerging need of modern radiation therapy is to develop preventive approach to risk management i to improve the patient safety.

Objective

The objective of this research is to identify and assess risk associated with radiation therapy practice in Bosnia and Herzegovina.

Methods

An anonymous, voluntary electronic on-line radiation therapy incident reporting system (IRS) was created. IRS consists of four sections containing questions about working environment, incident occurrence, root causes and contributing factors, and incident severity assessment. Data collected using IRS were used to create taxonomy of incidents in radiation therapy. Risk assessment was made using Risk Matrix method. Research was made using the data collected from first 60 incidents reported to IRS.

Results

Based on probability and frequency of incident occurrence and severity of consequences, it was assessed that 41.7% of incidents had low risk level (L), 50% of incidents had moderate risk level (M), and 8.3% of incidents had high risk level (H). Radiation therapy risk profile based on risk assessment results clearly shows that incidents with low frequency, low occurrence probability, but high consequences severity level have highest level of risk.

Conclusion

The results of this research confirm that the electronic on-line radiation therapy IRS allows the identification and classification of the most significant risk factors in radiotherapy and prevention of serious incidents occurrence.