As radiation therapy becomes increasingly vital in cancer treatment, many centers are turning too outsourced medical physics support to address staffing challenges and access specialized expertise. Though, this trend introduces potential risks to patient safety, prompting concerns from regulatory bodies like FranceS IRSN-which launched an examination into teh practice in 2020. Now, the French National Association for Medical Physics (ASNR) has released new guidance aimed at mitigating thes risks, emphasizing the need for careful planning, clear agreements, and strong collaboration between centers and external providers.
Radiotherapy centers are increasingly turning to outsourcing for medical physics support and the implementation of new technologies, a trend driven by staffing shortages, the need for specialized expertise, and the desire for operational flexibility. However, relying on external professionals can significantly impact a center’s internal organization, workflow, and communication between staff, potentially compromising patient safety.
A 2020 investigation by the French Institute for Radiological Protection and Nuclear Safety (IRSN) identified several factors that could jeopardize treatment safety when outsourcing is involved. These include insufficient oversight from the commissioning center, limited time for external providers to complete their work, inadequate qualifications among contracted professionals, inconsistencies in practices between the center and the provider, and a lack of thorough risk analysis.
To address these concerns, the French National Association for Medical Physics (ASNR) has published an operational guide, developed in collaboration with experts in medical physics and the social sciences. The guide emphasizes the critical importance of involving the radiotherapy center’s in-house medical physicists throughout the entire outsourcing process. Maintaining treatment safety, the ASNR recommends, requires collaborative discussions between the center and the provider, as well as among different professional teams.
The ASNR identified six key areas that often receive insufficient attention during external service delivery. These include:
- Developing a clear outsourcing strategy to define the scope of outsourced activities, identify needs and potential risks, and select the most appropriate approach.
- Formalizing the service agreement to clearly outline expectations, responsibilities, and resources for both parties, ensuring optimal working conditions.
- Managing the competencies of both the provider and the commissioning center, encompassing technical skills, software proficiency, experience, and familiarity with local practices.
- Investing resources from the commissioning center to support preparation, coordination, collaborative work, and follow-up activities. Outsourcing does not eliminate the need for internal investment; the level of investment will vary depending on the specific service and working arrangements.
- Implementing robust risk management procedures to identify and mitigate potential hazards associated with the external intervention and its integration with existing center operations. This requires joint effort, transparent communication, and proactive risk assessment.
- Ensuring the provider understands and adapts to local practices and organizational structures, and that the commissioning center fully integrates the provider’s work into its own processes. This necessitates dedicated time and resources for knowledge transfer and skill development.
The ASNR also provides a self-assessment tool as an appendix to the guide, designed to help stakeholders structure their considerations and identify necessary actions when engaging in external medical physics services for radiotherapy. This guidance is particularly relevant as healthcare systems worldwide grapple with increasing demands for radiation therapy and the challenges of maintaining a highly skilled workforce.
