Application of failure mode and effect analysis to tomotherapy treatment delivery

The failure mode and effect analysis (FMEA) approach was used to assess the potential risks for patients during the delivery of tomotherapy treatments. This study, which completed a previous investigation recently performed on the tomotherapy pretreatment phases, enabled the delineation of the delivery process tree and the identification of 30 failure modes, 9 of which were judged to be of particular concern. Novel solutions and strategies for dealing with these failures are accordingly proposed, and addressed both to the clinical staff directly involved in the delivery process, and to the machine vendor.