Frequently asked questions (FAQ):
  • General questions
  • Confidentiality and safety
  • Benchmark
  • Practical
Tab 1
Please check the enclosed link for more info on PRISMA-RT.be.
PRISMA-RT.be is fully financed by the Belgian federal Government through the National Cancer Plan; more specifically Action 16: radiotherapy and oncological imaging in the domain Care, Treatment and Support of Patients. For more info, click on the following link.
The PRISMA-RT network is conceived as an important tool in the continuous quality improvement of radiotherapy in Belgium. As such the financing is a fixed part of Action 16 of the Cancer plan, established on 10/03/2008. The continued support of the Cancer Plan was reconfirmed in the federal coalition agreement of 01/12/2011.
Tab 2
Yes, as explained in the section about the benchmark all data is anonymous. No patient data is retained.
The PRISMA-RT network operates under the auspices of the College of Radiotherapy, the multi-disciplinary group that assures quality of radiation-oncology in Belgium. The College is installed by the federal government and consists of 8 appointed physician members. The College retains a committee of external experts, physicists, nurses, quality managers and other stakeholders.
The College is the sole authority for release of data from or derived from the benchmark.
A board of experts oversees the running of the benchmark, including quality assurance and trend analysis. This workgroup is composed of the different stakeholders, communities and disciplines involved in radiotherapy in Belgium. The College of Radiotherapy has two appointed representatives in the board of experts that act as the benchmark administrators.

The current composition is:
  • Dr. Vincent Remouchamps, College of Radiotherapy
  • Dr. Karin Stellamans, College of Radiotherapy
  • Alain Dehaene, Adheco
  • Kristel Van Rode, Adheco
  • Frederik Vanhoutte, QMRT.be
  • Aude Vaandering, QMRT.be
  • Anitha Batamuriza-Almasi, quality manager
  • Alex Rijnders, physicist
  • John Vercauteren, quality manager
  • Dr. Pierre Scalliet, radiation oncologist
  • Nathalie Deman, physicist
  • Nathalie Flamée, quality manager
  • Mia De Baere, quality manager
  • Dr. Philippe Coucke, radiation oncologist
The benchmark database has three access levels.

Full access: complete access to the benchmark, including the identity of the reporting centers, is restricted to the College of Radiotherapy. The two College members that are part of the board of experts manage this access. The College can use its full access to initiate quality projects in an efficient way.

Center access: Each center has access to its own data and can benchmark it to the data of the 24 other centers. At this access level, the identity of the other centers is not visible.

Administrative access: the datacenter administrators, TPSC and the representative company Adheco have access to the data for database administration and maintenance.
Access is restricted by unique access codes assigned to each center.

The Patient Safety Company has set out a framework of governance and accountability for information security management. It forms the basis of an Information Security Management System (ISMS) to protect The Patient Safety Company’s and its client’s data by maintaining:
  • Confidentiality: protecting information from unauthorized access and disclosure
  • Integrity: safeguarding the accuracy and completeness of information and preventing its unauthorized amendment or deletion
  • Availability: ensuring that information and associated services are available to authorized users whenever and wherever required.

The Patient Safety Company (TPSC) acknowledges the importance of information security and privacy of data and is fully committed to reduce potential risks and to take all necessary measures within its power in order to guarantee data availability and to provide secure process data management and storage.

One of the most important concerns, besides securing TPSC's own process and management controls, is selecting Third Party Providers, Hosting partners. The hosting partners have all been selected carefully to ensure 24x7 availability and to comply with international and local standards for the region or country. Certifications and audit reports can be shared on request and by signing a Mutual Non-Disclosure Agreement with the hosting partner.
Tab 3
The benchmark is a collection of root cause elements, one or more per event report, consisting of
  • Center number
  • Date of the report
  • One Eindhoven Classification code
  • A variable number of context variables
No other data is stored. The contents of the originating event, stored in the event report-and-learning systems of the participating centers, are never transferred to the benchmark database.
In the TPSC PRISMA-RT platform:
  • A report is sent to the benchmark environment when the form is completed. If no PRISMA analysis is available yet, placeholder data consisting of the date of the report and the number of the center is put in the benchmark. These empty placeholder entries do not show up in benchmark reports.
  • If a PRISMA analysis is entered, the classification codes and context variables are added to the benchmark and will from then on appear in the statistics and benchmark.

In third party systems:
  • When using a third party system for the PRISMA- RT analysis manual or automated data export is necessary. Please refer to the administrator of your system for this information.
In the TPSC PRISMA-RT platform:
  • Data changed and saved in the analysis of a report is automatically updated in the benchmark; i.e. if a classification code or context variable is changed, then this information will be updated in the benchmark. The benchmark is at all times synchronized with the PRISMA-RT platforms of each centers.

In third party systems:
  • When using a third party system for the PRISMA-RT analysis, manual or automated data synchronization is necessary. Please refer to the administrator of your system for this information.
The board of experts oversees the quality of the entered data. The board of experts establishes the guidelines for reporting and analysis. An important tool is an inter-rater reliability test to evaluate the reliability and reproducibility of the analysis results. Ideally, each analyst will take this test yearly.
The board of experts makes a list of 50 representative root causes and reviews these yearly. The board discusses and classifies each root cause, establishing the so-called 'Golden Standard'.
During a PRISMA-RT workshop each participant will have the opportunity to classify the 50 described root causes according to the Eindhoven Classification methodology (ECM). Finally the results of these classification codes are compared to the 'Golden Standard' and discussed. After the workshop the test and golden standard are available for download so the analysts that could not attend the workshop can participate.
The reliability percentage serves as a quantitative measure and should ensure analysis uniformity between the observers/analysts. It also allows the quality manager of each center to follow the training needs of the analysts.
Tab 4
Yes, at this moment only available in Dutch; A French and English version will also be provided, timing to be confirmed.
No, root causes of near-incidents are identical to root causes of accidents and calamities. It is therefore important that all events are included in the benchmark (incidents, near-incidents, quality breaches…). However, only those events with analyzed PRISMA data are visible in the benchmark.
If a PRISMA analysis cannot be carried out for all reports, it should be performed systematically for one of every N events (N to be defined by department). Putting a threshold on severity or type of incident holds the risk that vital information is overlooked.
Yes. In anticipation of the final context variables, a PRISMA analysis can still be made. If necessary the existing Dutch context variables can be added during analysis or the final Belgian context variables can be added afterwards.
Context variables have been defined by the board of experts and were subject to a test run. They will be integrated into the institutions’ platform once the translation and user guidelines are ready.
The final Belgian context variables will be available from September 2015.