External review systems for radiation oncology facilities – clinical audit versus other review systems

Abstract

Background

Between 1996 and 1999 project team of ExPeRT, catalogued four external review systems of health care facilities in the European Union and countries associated with EU.

Aim

The aim of this paper is a/ to identify and compare currently existing external review systems for radiation oncology facilities and b/ to distinguish main differences between clinical audit and other external evaluation models and c/ to identify where those models are currently used in European Union member states.

Materials and Methods

Based on the literature review and the survey conducted between January and April 2007 among representatives of 67 national societies (for diagnostic radiology, radiotherapy and nuclear medicine) in European Union member states, the analysis of existing external review systems in radiation oncology was performed. Relevant information about purpose, scope and methodology of evaluation process for those systems were surveyed.

Results

The response to the questionnaire was 72%. Only a few countries did not supply any reply in spite of repeated enquiries to several recipients. Six main categories of systems aiming at measuring the quality of service management and delivery were identified: professional peer review –based schemes, hospital accreditation, accreditation in terms of ISO standards, award seeking, certification by International Standards Organization, and clinical audit.

Conclusions

Though the methodology and terminology of the five main external review systems differ, a constant movement towards collaboration and convergence of those models has been observed. Due to the social, political, and economical aspects of each European country, the different audit systems have been implemented either on voluntary or mandatory basis.