Learning in radiation oncology: 12-month experience with a new incident learning system

Introduction:Safety and quality improvement are essential to clinical practicein radiation therapy as planning and treatment increase in complexity andsophistication. An incident learning system (ILS) is a safety and qualityimprovement tool that can aid risk mitigation to improve patient safety andquality of care. The aim of this study was to quantify the impact ofimplementing a new e-ILS,LearningInRadiationONcology (LIRON), onreporting and safety culture within a local health district (LHD).Methods:TheILS (LIRON) was implemented in 2020 with the intent of tracking actualincidents, near misses and procedural non-compliances for analysis of rootcauses and contributing factors. A survey was conducted after 12 months ofLIRON use, and distributed to radiation oncologists, radiation therapists andradiation oncology medical physicists within the LHD. Results were comparedwith the responses to a pre-ILS implementation survey, to review changes instaff perceptions of safety culture, barriers to reporting and ILS understanding.Results:Survey response rates were similar at baseline and at the 12-monthfollow-up, 64% and 63%, respectively. Findings showed increased ILSparticipation (49-71%), increased perception of no barriers to reporting (34-43%) and increased encouragement to report (37-43%). Greater confidence inthe department's ability to learn from the ILS was evident (24-46%).Conclusion:Initial findings of LIRON implementation show positive impactbut warrant further long-term review for greater understanding of its impacton staff perceptions, safety culture and improving departmental processes