Riga, Latvia

Comprehensive Quality Management in Radiotherapy – Risk Management and Patient Safety

Safety management is deeply embedded in the culture of radiation therapy, in the daily attitude of staff members, within the team and also with the patients. What exactly is the level of risk? How can we measure it? How can we manage patient safety in daily radiotherapy also in relation to rapid development of technology?  These are the main topics of this course.

The course is aimed at radiation oncologists, medical physicists, radiation technologists, (quality/safety) managers and any other health professional interested in risk management and patient safety.

Course directors

  • Brendan McClean, Medical Physicist, St Lukes Radiation Oncology Network, Dublin (IE)
  • Petra Reijnders-Thijssen, Manager Quality & Patient Safety, Maastro, Maastricht (NL)


  • Mary Coffey, Adjunct Associate Professor, Division of Radiation Therapy, Trinity College, Dublin (IE)
  • Marcel Stam, Radiation Oncologist, Radiotherapy Group, Arnhem (NL)
  • Aude Vaandering, Radiation Technologist, UCL Cliniques Universitaires St. Luc, Brussels (BE)
  • Nicolas Pourel, Radiation Oncologist, Institut Sainte-Catherine, Avignon (FR)

This course is part of a two-year cycle on quality management in radiotherapy, consisting of two complementary modules:

  • Risk management and patient safety
  • Quality improvement and indicators.


Industrial and medical activities expose operators, patients and the general public to the risk of accidents that cause corporeal or environmental damage (or both). Harm to operators is very uncommon in radiotherapy, but harm to patients does happen and has had considerable press coverage in many European countries. These widely publicised accidents have focused the attention of both the radiotherapy community and the regulatory authorities on the appropriate preventive actions that could be taken to avoid their repetition.

Fortunately, accidents that actually result in harm to patients are rare. Conversely, small irregularities in the radiotherapy process are very frequent, many hundreds per year in every department. A key to the understanding of the genesis of accidents is the fact that these small irregularities (called precursors), as benign as they seem to be when considered in isolation, can mesh together to result in a fully developed accident. An accident is not the result of very uncommon irregularities; it is the coincidence of very common irregularities that unfortunately occur at a given point in time.

Though accidents are rare, this course aims to identify their precursors. Actively working on these precursors (registration, description, classification), and working on improvements in the radiotherapy process (prevention) is an efficient way to substantially decrease the risk of accidents. In some European countries it is even mandatory to record and report on precursors.

In addition, the course will also discuss preventive analysis that can be done on any radiotherapy process, by trying to identify critical elements that need specific monitoring or quality controls (failure mode analysis). An efficient incident recording system presupposes a good communication both within and sometimes outside the department. Elements of communication are therefore also discussed during the course with a final role-play as an illustration.

Learning outcomes

By the end of this course participants should be able to:

  • Understand the cause, frequency and effects of incidents/accidents in a radiotherapy department
  • Understand the principles of reactive management to incidents (registration, analysis and feed back to the Quality Management System) and of proactive management of safety (incident prevention)
  • Consider risk management in relation to the changing of ICT dynamic in radiotherapy processes
  • Know how to communicate around radiotherapy incidents, with the patient and his/her relatives, within the department itself and with the media.


Course content

  • What is risk? Psychology of making mistakes
  • Ethics for radiation medicine professionals. A just reporting culture
  • Example of the genesis of an accident (take a recent example, relevant to radiotherapy of today)
  • addressing new risks concerning AI, cyberattack


  • ROSEIS: the precursor in Europe. Frequency of incidents (who reports and what type of incidents are reported)
  • Taxonomy and classification, distinction between incident and accident
  • Analysis and return on experience (root cause analysis)
  •  PRISMA as example (The Netherlands)
  • Benchmarking
  • Bowtie, scenario analyses
  • Health failure mode and effect analysis (HFMEA), a prospective risk management method
  • Practical exercises (hands on)
  • Communication:
    • to the patient
    • to the media
    • to the organisation (departmental, hospital level)
  • Specific training of staff, internal and external (team management)
  • Comprehensive quality management in Radiotherapy Legal aspects of incident reporting
  • Performance indicators.



The two courses on Quality Management, Risk Management and Quality Assessment, have been designed to be complementary and it is recommended to attend both to get a complete picture of quality management. However, the order in which they are taken does not matter. To fully profit from the course it is recommended that participants have at least three years’ experience in a radiation oncology or medical physics department to have a complete picture of the radiotherapy process.


Teaching methods

  • 23 hours of lectures
  • 6 hours of practical workshops.


Methods of assessment

Evaluation form



A draft programme is here.

Key words

Patient safety, risk management, VUCA.


Application for CME recognition will be submitted to the European Accreditation Council for Continuing Medical Education (EACCME), an institution of the European Union of Medical Specialists (UEMS). EACCME credits are recognized by the American Medical Association towards the Physician’s Recognition Award (PRA). Information on the status of the applications can be obtained from the ESTRO office.

Radisson Blu Latvija Conference & Spa Hotel, Elizabetes str. 55, LV-1010, Riga, Latvia.

Accommodation booking can be made via latvia.sales@radissonblu.com or +371 6777 2332 mentioning ‘Event ESTRO/Agnès DELMAS


ESTRO members can order products at substantially reduced prices. To benefit from the member registration rate, you must subscribe for the ESTRO membership 2024 BEFORE registering to the course. To become an ESTRO member, benefit from the member registration rate and discover the many other member advantages, please visit the membership page.



Early rate

Late rate


  800 EUR

 900 EUR

ESTRO Members

  625 EUR 

 775 EUR

In-training members*

  475 EUR

 625 EUR

* Members with specialty RadiationTherapist (RTT) may register at the In-Training fee

Early rates are applied up to three months before the starting date of the course.

Late rates are applied three months before the starting date of the course.

The fee includes the course material, coffees, lunches, and the social event.

Advance registration & payment are required.

Access to homework and/or course material will become available upon receipt of full payment.

Insurance and cancellation

ESTRO does not accept liability for individual medical, travel or personal accidents or incidents. Participants are strongly advised to take out their own personal insurance policies.   

For any cancellation made by the course or workshop participant, ESTRO School Events Cancellation Policy will be followed and all stated penalty fees will be applied. 

In the unlikely event that ESTRO would need to cancel the event, ESTRO will reimburse the participants in full for the registration fee. ESTRO will not refund any travel and accommodation expenses.

Reduced fees

Members from emerging countries may register at a preferential rate of 350 Euro. Emerging country fee applies to individuals from low-income and lower-middle-income economies according to the World Bank listing here.

Additionally, for this teaching course, all specialties from the following countries can benefit from this preferential rate: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Hungary, Macedonia, Moldova, Montenegro, Romania, Russian Federation, Serbia, Turkey, Ukraine.  In addition, medical physicists from Cyprus can email education@estro.org to apply for this fee.

The preferential rate of 350 Euro is granted automatically when you click on the  BOOK NOW  button and the

conditions below are met:

  1. Only ESTRO members for 2024 are eligible (please make sure your 2024 membership is in order before you click on the BOOK NOW button)
  2. The application is submitted 3 months before the course start date.
  3. Only one course per person per year can be subsidized by ESTRO
  4. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  
  5. The are limited spaces available for each course in the price category. Places are granted on “first come first serve” basis.