Nov 05, 2020
Machine QA at the Cancer Centers of Southwest Oklahoma is now simpler, faster and more standardized with the AQUA departmental quality management system
Medical physicist Stephen Oyewale
The Cancer Centers of Southwest Oklahoma (CCSO) have radiation oncology facilities at three locations in Lawton, Altus and Duncan, Oklahoma, offering quality cancer care to the people of southwest Oklahoma close to their homes. However, with four linear accelerators spread over three locations, machine QA was a time-consuming task for the physics team.
“One of our satellite centers is 45 minutes away and the other is an hour away,” says medical physicist Stephen Oyewale, who is based in Lawton. “As a result, I was spending at least three and a half hours every week traveling alone. In addition to this, some of our QA tests, such as the MLC test and the cone beam CT test, were quite complicated, time-consuming and very subjective.
“Then a colleague at another facility introduced me to AQUA,” he continues. “I was able to see some of the tests being performed in her department and I saw the potential for making our machine QA easier and more objective. I was attracted to the automation and ease-of-use of AQUA. For some tests, once started, they run by themselves and you just come back when it’s finished to analyze the results. It looked simple enough that I could easily train someone else to perform these tests.”
“I was attracted to the automation and ease-of-use of AQUA. For some tests, once started, they run by themselves and you just come back when it’s finished to analyze the results.”
AQUA was installed at CCSO in July 2019. With AQUA’s library of pre-installed tests, many of their machine QA tests were good to go right from the start. For some additional tests that required a little site-specific customization, the initial set up was completed in just one evening.
“It was very quick and easy to get started,” Oyewale comments. “The fact that the AQUA test library is customizable was important for me. I like that I can adjust or add tests because we are constantly looking at how we can improve our processes. This is one of the things that drew me to AQUA.”
Improved time management
Radiation therapists at Cancer Centers of Southwest Oklahoma
Oyewale has been able to delegate many machine QA tasks to radiation therapists, after a basic introduction to AQUA, which has reduced his need for traveling between sites considerably.
“Automation of some tests in AQUA, such as the MLC test, not only saves time but also means I can delegate tasks to other colleagues, increasing overall efficiency,” he explains. “Our working day is from 8 a.m. to 5 p.m., but the linacs are not always being used during that time. There might be a break between patients. Now, due to AQUA’s ease-of-use and automation, I can ask a radiation therapist to quickly run a QA test for me during this time. The MLC test takes them just seven minutes to perform, for example. Previously, I had to wait until after hours or come in at the weekend to get access to the linacs. So, delegating certain tests to be performed when the linacs are free has saved me a lot of time and reduced out-of-hours work. I have less need to go off-site because I can simply look at the results in AQUA.
“For the daily QA performed by the therapists every morning, they open up AQUA and it tells them what they have to do that day,” Oyewale continues. “Some of our third-party QA devices are linked directly to AQUA, allowing results to be recorded automatically. Results for some other tests need to be entered by the therapist, but AQUA prompts them from an intuitive dashboard. It also alerts them if anything requires attention, so they are happy and confident to use it.
“In total, I’m saving at least six hours per week, not only due to reduced traveling time but also due to more efficient QA processes and management with AQUA,” he comments. “I have been able to spend this time on other tasks and more pressing issues. For example, we started a stereotactic program this year and so I have appreciated having more time to focus on this.”
“In total, I’m saving at least six hours per week, not only due to reduced traveling time but also due to more efficient QA processes and management with AQUA.”
Cancer Centers of Southwest Oklahoma at Duncan
Centralization of complete machine QA data
AQUA simplifies and streamlines the management of QA processes within the department. Previously, machine QA test results were recorded in folders located close to the equipment but now all the test details and results are recorded in AQUA. Eliminating the need for paper and folders, AQUA provides centralized QA data, which can be monitored and accessed easily from any computer in the department, and at any of the three sites.
“I wanted something more electronic where I could check on things from anywhere in the department,” says Oyewale. “Now everything is recorded in AQUA, I can easily track if something has not been performed or if anything needs addressing. In fact, AQUA notifications will alert me to any issues. For reporting and audits, I don’t have to go looking in folders. I have everything from each site to hand in AQUA.
Cancer Centers of Southwest Oklahoma at Altus
“Sometimes the State Department visits us without notice to audit our QA processes,” he adds. “Previously, I had to scramble around for individual folders to show them our data. Now I can just open AQUA on a computer and have everything right there in one place. That has been impressive and saves a lot of time. The reports available in AQUA are everything we need, and they are customizable as well, which I love.”
“The reports available in AQUA are everything we need, and they are customizable as well, which I love.”
High quality of tests
Cancer Centers of Southwest Oklahoma at Lawton
“The library of tests in AQUA is a helpful starting point, including most of the tests we require according to TG142 guidelines,” Oyewale comments. “The quality of some tests is better than I experienced before. For example, the MLC test I used previously called for some visual observation, which was very subjective. The MLC test in AQUA is more objective and standardized, where the results do not depend on whoever is performing the test. Similarly, the monthly cone beam CT test is automated in AQUA, making it easier, faster and more objective.”
“AQUA has simplified our machine QA and has brought improved time management to our department,” he concludes. “It has freed up so much of my time, I would not want to go back to the way things were before.”
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