PT - JOURNAL ARTICLE AU - Kawamura, Hidemasa AU - Komatsu, Yasuhiro AU - Tanaka, Kazumi AU - Kanamoto, Masafumi AU - Tobe, Masaru AU - Usami, Chisato AU - Hinohara, Hiroshi AU - Oshima, Kiyohiro AU - Kitada, Yoko AU - Tsuda, Kazuhisa AU - Ogano, Tomoaki AU - Shimada, Hirofumi AU - Ohno, Tatsuya TI - Implementation of a rapid response system at an isolated radiotherapy facility through simulation training AID - 10.1136/bmjoq-2021-001578 DP - 2022 Jan 01 TA - BMJ Open Quality PG - e001578 VI - 11 IP - 1 4099 - http://bmjopenquality.bmj.com/content/11/1/e001578.short 4100 - http://bmjopenquality.bmj.com/content/11/1/e001578.full SO - BMJ Open Qual2022 Jan 01; 11 AB - 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.