[en] The initiated discussion about formalizing of the companionship has created a simple educational tool, reproducible and transferable to other services. The newcomer is well supported in all stages of acquisition of operating rules and safe operation. The registration of acquired data on portfolio allows final and objective validation of the department head. (N.C.)

[en] In February 2007, the radiation therapy department of the Jean Monnet Hospital in Epinal (France) has stopped the radiotherapy treatments after the discovery of a radiotherapy accident and bad practices leading to overexposure of patients between 1987 and 2006. The Regional Cancer Center 'Centre Alexis Vautrin' in Nancy (France) was given the task of the new start of treatment activity. From February 2007 to January 2008, actions of training, updates of equipment and practices have been performed in the Epinal Hospital, guided by the quality approach, allowing the treatment of new patients in February 2008, with the radiation oncologists and the medical physicists of the Centre Alexis Vautrin, with the highest conditions of security and confidence

[en] Since 2007, the Centre Alexis-Vautrin Cancer Institute in Nancy began its safety and quality assurance management policy in the department of radiation oncology. This development induced a collaborative work flow between the quality unit and the department of radiation oncology, with a definition of the responsibilities. The quality unit provides its methodology for the quality assurance, the professionals of the radiation oncology department their expertise. In parallel, a quality referee was nominated in the radiation oncology department to implement the projects for improvement, linked with the quality assurance unit, and under the control of the radiation oncology department staff. (authors)

[en] Purpose. - We previously presented a systematic and structured approach to acquire an accurate functional model of the patient's process in radiotherapy. This approach relied on new functional structuring patterns, derived from system engineering and knowledge engineering. Additionally, we propose a complementary methodical process for the dysfunctional analysis of the obtained functional model. Materials and methods. - The procedure is based on joint implementation of two qualitative methods named 'Failure modes and effects analysis' (FMEA) and 'Hazard and operability' (HazOp). Results. - All the technical, the human and the organizational dimensions of the patient's process are pooled in a unique, exhaustive and detailed dysfunctional analysis. The application of this systematic approach within a particular institution can precisely identify the risks incurred by patients in care, but also highlight the logical sequence between precursor events and incidents. Conclusion. - The dysfunctional analysis presented in this document will be used for the development still in process of quantified risk models. (authors)

[en] Purpose. - This document presents a systematic and structured approach for functional modeling for risk analysis in radiotherapy, aiming to reconcile the need, on one hand, for a method that can be applied generally and, on the other hand, for a method that provides a highly precise model. Materials and methods. - The approach relies on new functional structuring patterns and flux analysis, derived from system engineering and knowledge engineering. Results. - The method affords strong support for the development of detailed models of the patient's process through a department of radiotherapy. Lack of structure of the actual process in a particular department may be easily identified leading to the development of specific procedures for the improvement of security. Conclusion. - Modeling approach derived from engineering may be used for functional modeling for risk analysis in radiotherapy. (authors)