All participants in the radiotherapy treatment delivery process are largely invested in reducing errors and providing quality treatments. Errors that occur during the delivery of treatment can be catastrophic for both the patient and facility as a whole. A comprehensive error reduction program is a critical tool in the quest to reduce mistakes. MERP provides a complete system for analyzing fundamental reasons for the failure or inefficiency. Risk reduction strategies can then be more effectively deployed across the entire organization, whether large institutions or free-standing centers. Without an error reduction program, centers run a greater risk of being exposed to disadvantageous and potentially injurious consequences. Failure to embrace a patient safety program may result in undesirable outcomes:

1. Greater opportunity for occurrence of medical or sentinel events,
2. Increased potential for patient/physician litigation,
3. Lack of process for assessing tangible and measurable improvements in patient safety,
4. Increased possibility of violations involving state and federal radiation safety regulations,
5. Loss of “self-identification” to preclude citing of violations by state, NRC, or CMS inspectors,
6. Compromise in ability to mitigate sanctions and enforcement actions (e.g., civil penalties and newspaper releases) levied by state and NRC inspectors,
7. Deficient compliance program for enforcing fraud/abuse laws related to Medicare reimbursement for errors found in charge capture and billing activities,
8. Higher facility liability and physician malpractice insurance premiums,
9. Potential failures to meet certain facility certification standards as established by The Joint Commission, ACR, ACRO, and certain state agencies,
10. Blurred system of accountability designating “who is responsible for a particular process, action plan, and error approval”,
11. Unclear process for modifying or creating new department procedures based on action plans from actual medical events,
12. Failure to meet various state and federal initiatives to reduce medical errors, increase patient safety, and decrease unwarranted expenses,
13. Absence of continuous improvement model for increasing quality, lowering medical costs, and increasing profitability.
    
    

In addition to overall risk reduction, efficiency plays a significant role in radiation oncology. Pressure to do more with less is consistently present at every level of clinical work. Inefficiencies can potentially cripple facility operations. MERP allows for more effective utilization of your limited resources. Once problem areas are identified, MERP helps create scales of efficiency that best optimize allocation and deployment of staff and physicians.

Lastly, establishing an organizational culture of patient safety is paramount to reducing errors. Processes in health care organizations have historically been designed based on the premise that little will go wrong. Often when things go wrong, the individuals involved are retrained, punished, and sanctioned. This widely held view, however, is seriously flawed. Conversely, organizations cannot afford to shelter poor safety practices resulting from an environment in which errors are not openly identified and reported. MERP serves as an effective tool in helping create a culture of patient safety by focusing more on process failure, not who made the error. MERP works as a ready-made tool for reducing preventable system-related errors by identifying mistakes, measuring improvement, and increasing patient safety. MERP goes further by stepping through a thorough and credible root cause analysis for identifying the basic or casual factor(s) underlying performance. MERP helps facilitate an environment where safety practices are embraced at the working level.