IMPACT OF STAKEHOLDER ENGAGEMENT AND UNDERLYING FACTORS ON THE DESIGN, EVALUATION, AND KNOWLEDGE TRANSFER OF AUTOMATED QA TOOLS IN TWO RADIATION ONCOLOGY DEPARTMENTS PRIOR TO IMPLEMENTATION

The physics pre-treatment quality assurance (QA) step is the step mostly likely to detect potential safety events in the radiation therapy process. However, there is a need for improving the physics pre-treatment QA checklist with the process relying heavily on human inspection and evidence that errors still occur. The purpose of this study is to explore the impact of stakeholder engagement and underlying factors in the design and evaluation of an automated physics pre-treatment QA checklist. This work was done through knowledge transfer between two radiation oncology departments at the University of North Carolina (UNC) and the University of California-San Diego (UCSD) prior to implementation by first exploring factors underlying the design, use, and maintenance of the current physics pre-treatment QA checklists using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. An automated physics pre-treatment QA checklist (“PhyCheck”) prototype was developed at UNC, which demonstrated increased usability and decreased cognitive workload (CWL) compared to the current checklist. Safety events captured using the current physics pre-treatment QA checklist and qualitative data on automation and safety demonstrate the potential for automation to catch safety events and outline key barriers for automation. The engagement of stakeholders led to knowledge transfer between institutions and both institutions meeting the threshold for pre-implementation outcomes. This study highlights the importance of stakeholder involvement and engagement and outlines the underlying factors in the design, evaluation, and pre-implementation of health technology tools.