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Experiences of daily use of a database for linear accelerator quality control
McGrath N, Stilwell E, Budgell G, Beck J, Aziz T
The Christie NHS Foundation Trust
McGrath N, Stilwell E, Budgell G, Beck J, Aziz TChristie Medical Physics & Engineering
The Christie NHS Foundation TrustManchester
Overview
BackgroundDaily output and QC checks
Linac QC checksProblems and solutions
The Christie NHS Foundation Trust
Problems and solutionsFuture solutions
Conclusions
Background and Purpose• A database has been developed (MS access)
and brought into routine use for daily output checks and quality control (QC) check results
• The need for a database:• Paper-light working
The Christie NHS Foundation Trust
• Paper-light working• Handwriting• Consistency of data recorded
Background and Purpose
• Satellite working:• 16 linear accelerators within
the Christie network • Database has been in use for:
The Christie NHS Foundation Trust
• Database has been in use for:• 18 months for linac QC • 30 months for daily output
checks
Daily output and QC checks
• Check-boxes are ticked to record that the daily QC tests have been done
• Ion chamber/daily check device results entered• Doses are calculated by the database using
The Christie NHS Foundation Trust
• Doses are calculated by the database using stored calibration factors and the pressure from a networked barometer
• An instant green/amber/red tolerance is applied to the results.
Daily output and QC checks
• Easy verification of results by a physicist• Saves time• Avoids calculation errors
• Allows remote checking of results between sites
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• Displays of monthly results are available
Linac QC
• A form is generated for each linac QC test• Date, time and staff name are automatically
entered• Data boxes are set as compulsory or optional,
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• Data boxes are set as compulsory or optional, as required
• Calculations are performed automatically• Results compared with baseline data stored
within the database
Linac QC
• Tolerances are applied• Can be linac specific if required• Out of tolerance results are flagged as red
• External files can be linked to forms to record data• Graphs of individual MLC leaf positions
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• Graphs of individual MLC leaf positions • Shortcuts to work instructions• Shortcuts to QC test schedule spreadsheets
• Opened from the database• Tick off to record that the tests have been completed
Problems and solutions
• Gaining familiarity and coping with change!• Replicating the conveniences of a paper log-
book in an electronic form • Final conclusions from a session
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• Final conclusions from a session• Identifying what was carried out during a QC
session• Passing on information between sessions
Problems and solutions
• Results and final conclusions from a session• QC session has to be concluded with a sign-off form• Tick box indicating that linac is fit for clinical use
• Identifying what was carried out during a QC session• Tick-boxes to show which tests have been performed
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• Tick-boxes to show which tests have been performed• Free text box for conclusions and comments
• Passing on information between sessions• Electronic notes system• Checked before the next QC session• Signed and dated when issue has been addressed
Problems and solutions
• A series of search tools has been designed to allow quick and thorough review of data• All occasions of a specified test filtered for
linac and date range• All the tests performed on a linac in a given
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• All the tests performed on a linac in a given date range • Results can be directly accessed
• Reports exist to allow all the sign-off forms in a specified date range to be reviewed• Used in monthly QC review meetings
Future solutions
• Constantly improving and updating • Extension of the database to include
• Simulator QC• Superficial Unit QC
The Christie NHS Foundation Trust
• Superficial Unit QC• ICRs• Sr checks
Conclusions
• Improved consistency of data recording and results• A number of QC tests have become quicker to carry out• Easier to review results, plot trends and monitor QC
• Can be done remotely across multiple sites• New tests and improvements can be implemented quickly
The Christie NHS Foundation Trust
• New tests and improvements can be implemented quickly• Staff must adhere strictly to correct sign-off and
information transfer procedures• The time and effort required for it’s development has
been well worth it
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