Royal Devon and Exeter Hospital improves daily linac QA with integration and automation

Using integrated and automated QA for daily linac run ups improves efficiency, reduces staff workload and allows responsibility for linac run ups to be transferred from physicists to radiographers, as demonstrated by Exeter Oncology Centre.

Prior to the purchase of Sun Nuclear’s SunCHECK QA software platform and Sun Nuclear Daily QA 3 devices the daily linac runup was cumbersome, requiring separate systems to measure and record outputs. As a result of this workflow run ups were only performed by the medical physics team.

At the beginning of 2021 the medical physics department decided to update the equipment used for daily QA and opted for an integrated solution, including SunCHECK Machine and Daily QA 3s.

This gave the department a chance to rethink the whole morning QA process and the staff that could be involved in machine run ups.  As in every other NHS department during COVID-19, staffing had been stretched and the requirement to move responsibility of machine runs ups from a limited staff group was seen as increasingly necessary. The solution identified by the department that was being used by medical physics for secondary calculations, pre-treatment QA, in vivo dosimetry and some machine QA tasks promised greater workflow efficiency and was identified as the appropriate solution.

A work group including three radiographers, a physicist and an engineer divided up the training responsibilities. Physics and engineering set up workshops to ensure the radiographers had the background knowledge required to understand the complexities of the process. On set training using the Daily QA 3 took place over the course of a week, which was found to be more than sufficient to ensure competence in morning run ups.

Reviewing results
Results are reviewed by the physics team.

One of RD&E staff trainers, Tess Scott-Baxendale is quoted as saying: “SunCHECK has made training easier, as it has the step-by-step instructions for everyone to follow if they’re ever in doubt. The fact the measurements are colour coded green, amber and red means we can identify out of tolerance data easily and also know when to involve the duty physicist, ie if it is amber, we can continue running up the machine whilst physics/engineering are made aware of the result rather than stopping all together.”

Radiographers have said that their confidence in the Daily QA 3 means that they have welcomed learning this new skill, and that they enjoy being part of the morning QA team.

This more automated process being taken on by radiographers has had the additional benefit of freeing up medical physics time. This has allowed RD&E to reconfigure their servicing schedule, removing QA time from core hours benefiting patients and providing the medical physics team with more flexibility to utilise machine time after the clinical workload has finished to complete more complex QA.

Sun Nuclear’s SunCHECK QA platform is available in the UK from Xiel Limited.

Lead picture: A radiographer sets up the Daily QA3 for morning run up.

Submitted by Claire Harding, team lead radiographer, Royal Devon and Exeter Hospital.

This news story has been sponsored by the companies concerned and does not represent the views or opinions of RAD Magazine.

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