Creating a radiation oncology oriented safety culture within a large oncology practice: Lessons learned.

85 Background: Texas Oncology (TXO) is a dedicated oncology practice consisting of more than 400 physicians and 57 radiation oncologists at 52 sites of service. In order to enhance communications of the rad onc team, establish accountability by using metrics, and engage continuous improvement, we initiated a program to establish regional quality committees in each radiation oncology practice site. Methods: In 2015, the TXO leadership approved the formation of Regional Quality Committees (RQC) at each site. The key members of each RQC include a Physician Chair, a Physicist Co-Chair, Chief Therapist, Radiation Safety Officer, Dosimetrist, and Nurse. Meeting frequency was recommended monthly, but quarterly meetings were required. Meeting documentation reporting was required including a formal agenda, minutes for items discussed, and listing of attendees. Metrics with regard to RQC activities were reported and recorded beginning in 2016. The 2016 Action plan for the RQC at each site included documentation of timeout procedure, regular chart rounds, new patient conference, as well as a mortality and morbidity conference. Results: See table. Conclusions: Within 3 calendar quarters, a functional RQC was established in all 52 radiation oncology practice sites within TXO. Compliance with the action plan was high with regard to action items not requiring multiple physician participants (RQC committee, timeout, chart rounds, CQI projects, performance metrics). Compliance was lower in activities that required multiple physician participation. Verbal feedback was positive regarding the RQC program. Respecting time demands of physicians, education, and communication were identified as key success factors in the RQC program. [Table: see text]