Abstract
The traditional approaches to safety in risk activities have been applied to radiotherapy following the occurrence of serious accidents. This strategy is based on the characterization of specific risks and the definition of preventive and protective measures, particularly for the implementation of safety barriers. Evaluating the performance of safety barriers makes it possible, in theory, to determine the level of risk control. This article presents a literature review that highlights the limits of the safety barrier concept. To overcome these limitations, we then introduce the notion of “activities contributing to safety” (ACS). This concept allows us to better take into account the managerial, contextual, organizational and human dimensions of safety and to promote risk control through a more realistic approach.
Highlights
Radiation therapy is one of three major methods of treating cancer along with surgery and chemotherapy
We propose replacing the concept of safety barrier with that of an activity contributing to the safety of care (ACS)
One perspective of this research would be to further identify ambiguities and inconsistencies in the concept of safety barriers, including the distinction made between different types of controls, between a barrier and the preconditions necessary for its performance and/or the distinction made between accident prevention and recovery barriers and/or between safety barriers and control systems
Summary
Radiation therapy is one of three major methods of treating cancer along with surgery and chemotherapy. The second level is that of the specific methods used to analyse the risks of accidents and to define provisions to reduce their occurrence or the severity of their consequences These methods aim to characterise the risks and to define and implement successive and complementary countermeasures (equipment, operating limits, control and monitoring, etc.), often referred to as “safety barriers”. Since the occurrence of serious accidents in radiation therapy in France, this concept of safety barrier is used to evaluate the technical and human provisions defined to make. This care process safe (Meyrieux et al, 2012; François et al, 2010; Pernet 2013; Reitz, 2014; Brusadin et al, 2017; Thellier, 2017). These results make it possible in the discussion to propose the concept of an activity contributing to safety in order to cope with the limits of the concept of safety barriers
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