Development and execution of a pandemic preparedness plan: Therapeutic medical physics and radiation dosimetry during the COVID‐19 crisis

Abstract

The SARS‐CoV‐2 coronavirus pandemic has spread around the world including the United States. New York State has been hardest hit by the virus with over 380 000 citizens with confirmed COVID‐19, the illness associated with the SARS‐CoV‐2 virus. At our institution, the medical physics and dosimetry group developed a pandemic preparedness plan to ensure continued operation of our service. Actions taken included launching remote access to clinical systems for all dosimetrists and physicists, establishing lines of communication among staff members, and altering coverage schedules to limit on‐site presence and decrease risk of infection. The preparedness plan was activated March 23, 2020, and data were collected on treatment planning and chart checking efficiency for 6 weeks. External beam patient load decreased by 25% during the COVID‐19 crisis, and special procedures were almost entirely eliminated excepting urgent stereotactic radiosurgery or brachytherapy. Efficiency of treatment planning and chart checking was slightly better than a comparable 6‐week interval in 2019. This is most likely due to decreased patient load: Fewer plans to generate and more physicists available for checking without special procedure coverage. Physicists and dosimetrists completed a survey about their experience during the crisis and responded positively about the preparedness plan and their altered work arrangements, though technical problems and connectivity issues made the transition to remote work difficult. Overall, the medical physics and dosimetry group successfully maintained high‐quality, efficient care while minimizing risk to the staff by minimizing on‐site presence. Currently, the number of COVID‐19 cases in our area is decreasing, but the preparedness plan has demonstrated efficacy, and we will be ready to activate the plan should COVID‐19 return or an unknown virus manifest in the future.

Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners

“…General practitioners have been facing multiple challenges during the COVID-19 pandemic, such as a high risk of being infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) themselves [ 11 ], including the risk of mortality [ 12 ] and psychological impacts with regard to work and personal life [ 13 ]. Overall, pandemic preparedness (PP) is an important factor in being better able to manage the challenges of a pandemic [ 14 , 15 ].…”

Analyzing changes in radiotherapy treatment planning error reporting during the COVID-19 pandemic

“…Throughout the COVID-19 pandemic, radiation oncology departments modified traditional patient interaction procedures and implemented remote work to adhere to social distancing protocols. 7 , 8 , 9 , 10 , 11 The option for remote work has been available for several years. 13 However, the COVID-19 pandemic may have accelerated widespread implementation that would otherwise have taken place in the future.…”

“…Pods were created where on-site staffing of medical dosimetrists and physicists were limited to a select small group that rotated on a daily or weekly basis. 8 When on-site presence was not required, all work was performed remotely on virtual desktop access provided by institutions. Remote treatment planning involves accessing the treatment planning system (TPS) and other clinical databases off-site and allows for medical dosimetrists to create radiotherapy plans without physically being present at the treatment facility.…”

“…Such policies, known as pandemic preparedness plans (PPP) were developed by some radiation oncology facilities. 8 Pandemic preparedness plans were based on many factors with the common goal of achieving safe and effective care to patients. One center in the greater New York area achieved this by focusing on managing staff, implementing telehealth visits, reducing patient volume through categorization of treatment priority, encouraging multidisciplinary discussion, and maintaining a culture of safety.…”

“…Despite the shift to off-site operations for medical dosimetry and physics departments, plan checks, and physics coverage were fulfilled remotely in accordance with Nuclear Regulatory Commission (NRC) requirements. 8 Setup images that required review by physics prior to administering the first fraction of treatment were accessed through offline review with a virtual desktop. Establishing socially distanced staffing adjustments was not the only way clinics maintained a safe environment for patients and staff.…”