Effectiveness of the barcode certification system in preventing incorrect use of patient immobilization device in radiotherapy

The present study showed that using a barcode system could reduce the improper use of immobilization devices in patient positioning, by reviewing the incident/accident (IA) reports before and after the introduction of the barcode system. A barcode system is an effective tool to eliminate human error, which is essential for patient safety. In our institution, approximately 1700 patients were treated using external irradiation. We introduced a barcode system for patient immobilization devices used in external irradiation of radiation therapy. Radiation therapy cannot be performed until each immobilization device is authenticated by a barcode. The IA reports from 2010 to 2019, before and after the barcode system was introduced, were compared. During this period of time, 271 IA reports were submitted from our department, of which 16 reports concerned with patient setup. Analysis was performed using R, comparing the IA report before and after the barcode system was introduced. The number of the IA reports concerning patient positioning and immobilization decreased from 12 to 4 after the barcode system was introduced. We have also investigated the time efficiency of barcode certification system. The average treatment time per patient was 7 min both before and after the barcode certification was introduced, showing no significant change in time efficiency. In conclusion, an authentication system of patient’s individual therapeutic devices using barcode is a necessary tool to avoid the improper use of immobilization devices, misplacement of bolus, and improper couch shape.