CAT-ClinART

CAT-ClinART - Catalan Clinical Audit network for Quality Improvement in RT

Radiotherapy, due to the high radiation doses delivered to the patients, requires a strict quality management programme to assure the quality and safety of practice. Deviations from quality standards may compromise the efficacy and safety of the treatment by increasing toxicity or reducing tumour control [(Peters et al. 2010)] or by increasing the risk of incidents and accidents [Malicki et al. 2018]. In this scenario, clinical audit constitutes a key component of a quality management programme enabling evaluation of adherence to pre-defined quality indicators and protocols and the identification of practices which have the potential for improvement. The general aims of a clinical audit be to: (a) improve the quality of patient care; (b) promote the effective use of resources; (c) enhance the provision and organisation of clinical services; (d) further professional education and training [NICE 2022, Healthcare Quality Improvement Partnership 2020]. 

The importance of clinical audits, both internal and external has also been recognised by the European Commission in the BSSD 2013/59. Even if mandated by law following the implementation of BSSD, most EU countries lack of a permanent structure to conduct clinical audits. In the last 20 years the Catalan health authorities have only organised two audits in radiology departments and one in radiotherapy departments in Catalonia focused on the quality management system. These audits did not cover technical aspects as the auditors were not experts in the audited fields. Even if some radiotherapy departments have participated in dosimetry audits mainly linked to their participation in clinical trials, there are no dosimetry audit campaigns at a regional/national level.

The main objective of the project is to establish a regional (autonomous community) clinical audit structure for Radiotherapy in Catalonia following the model of B-QUATRO. The main objectives that compose the project are:

O.1. Develop a standardized methodology and a solid infrastructure to perform comprehensive clinical audits in Radiotherapy in Catalonia.

O.2. Design and create a training course on QUATRO methodology for clinical audits and the use of QI for quality monitoring and improvement in Radiotherapy.

O.3. Organize and conduct a first round of comprehensive pathology-based (prostate cancer) clinical audit campaign.

O.4. Prepare a proposal for a permanent clinical audit mechanism in Radiotherapy in Catalonia.

O.5. Raise awareness in the radiation therapy community concerning the importance of incorporating clinical audits as a tool to increase the quality and safety of radiotherapy procedures.

O.6. Facilitate the resources developed and lessons learned from the project to facilitate the implementation and scaling up of clinical audits in Radiotherapy in other Spanish regions and Member States.