Operations and Impact of a Specialty-Specific National Incident Learning System: Ten Years of Radiation Oncology Incident Learning System (RO-ILS).

Abstract

Incident learning is recognized by national and international organizations as a key component of maintaining safety and quality in health care. In 2014, RO-ILS: Radiation Oncology Incident Learning System was launched by the American Society for Radiation Oncology and the American Association of Physicists in Medicine with the goal of facilitating safer and higher-quality care in radiation oncology. This review discusses the structure of the RO-ILS program, its foundations and operations, as well as outcomes in terms of engagement and learning opportunities. RO-ILS operates under the auspices and protection of patient safety organization in the United States. As of the end of 2024, 781 facilities have enrolled in the program, representing a mixture of United States practice settings (private practice, community/academic, free-standing/hospital-based, and small/large). A cumulative 41,516 events have been reported to the patient safety organization, the largest volume of events compared to other national and international aggregated incident learning systems in radiation oncology. A minority of events (24%) are incidents, that is, events that actually reached a patient regardless of harm. Approximately 10% of events were rated as potentially severe or critical. A key feature of the RO-ILS program is reports and other releases aimed at education and quality improvement. Over 100 releases have been issued, including case studies, great catches, safety notices, and themed reports, as well as industry webinars and user meetings. While there is evidence of success and engagement in the RO-ILS program, current and future challenges include the quantity and quality of reported data, the ability to effectively extract information, further engagement of key stakeholders, and program sustainability. These must be addressed for RO-ILS to continue to fulfill the mission of supporting safer and higher-quality care in radiation oncology.