@article {Kawamurae001578, author = {Hidemasa Kawamura and Yasuhiro Komatsu and Kazumi Tanaka and Masafumi Kanamoto and Masaru Tobe and Chisato Usami and Hiroshi Hinohara and Kiyohiro Oshima and Yoko Kitada and Kazuhisa Tsuda and Tomoaki Ogano and Hirofumi Shimada and Tatsuya Ohno}, title = {Implementation of a rapid response system at an isolated radiotherapy facility through simulation training}, volume = {11}, number = {1}, elocation-id = {e001578}, year = {2022}, doi = {10.1136/bmjoq-2021-001578}, publisher = {BMJ Open Quality}, abstract = {A rapid response system is required in a radiotherapy department for patients experiencing a critical event when access to an emergency department is poor due to geographic location and the patient is immobilised with a fixation device. We, therefore, rebuilt the response system and tested it through onsite simulations. A multidisciplinary core group was created and onsite simulations were conducted using a Plan-Do-Study-Act cycle. We identified the important characteristics of our facility, including its distance from the emergency department; the presence of many staff with little direct contact with patients; the treatment room environment and patient fixation with radiotherapy equipment. We also examined processes in each phase of the emergency response: detecting an emergency, calling the medical emergency team (MET), MET transportation to the site and on-site response and patient transportation to the emergency department. The protocol was modified, and equipment was updated. On-site simulations were held with and without explanation of the protocol and training scenario in advance. The time for the MET to arrive at the site during a 2017 simulation prior to the present project was 7 min, whereas the time to arrive after the first simulation session was shortened to 5 min and was then shortened further to 4 min in the second session, despite no prior explanation of the situation. A multidisciplinary project for emergency response with on-site simulations was conducted at an isolated radiation facility. A carefully planned emergency response is important not only in heavy ion therapy facilities but also in other departments and facilities that do not have easy access to hospital emergency departments.}, URL = {https://bmjopenquality.bmj.com/content/11/1/e001578}, eprint = {https://bmjopenquality.bmj.com/content/11/1/e001578.full.pdf}, journal = {BMJ Open Quality} }