Quality Assurance and Audit Program

We recognised that this high technology procedure should be introduced and monitored in a way that would result in a minimal "learning curve" and with the best possible outcomes for patients. In order to achieve this we set up a prospective quality assurance programme and audit of performing the implants, its success as cancer treatment and side effects. Our programme which is ongoing has involved a number of important steps:

1. Preparation for the launch of the service took 18 months during which time we researched the area thoroughly and attended training programs at centres of international excellence.
   
   
2. We applied to the Ethics Committee for approval to introduce this Innovative procedure here in NZ. We have provided reports for the committee detailing the quality of the treatment, the cancer control rates and side effects. We are the only such service in New Zealand to have requested this detailed assessment.
   
   
3. We engaged one of the international authorities, Dr John Sylvester, Director of Education at the Seattle Prostate Institute to oversee our first cases, and have continued to keep up to date with ongoing advances in brachytherapy treatment.
   
   
4. We have had a significant number of our implants independently reviewed to validate our own assessments.
   
   
5. We perform post implant CT scans on all patients in order to assess the adequacy of dose and coverage of the prostate by the implant. It is not possible to assess the adequacy of the coverage without checking to see what happened. This is a vital part of quality assurance.
   
   
6. We audit the subsequent outcome of all our patients through regular serum PSA levels and checking for presence of any side effects. We present this data to the medical community for independent scrutiny.
   
   
7. We continue to attend advanced training programs overseas.
   
   
8. We have provided training and detailed consultancy advice for new implant programs both in New Zealand and Australia. (see papers presented)
   
   
9. We are committed to the provision of high quality prostate implanting systems, and believe that this is best achieved through a detailed system of continuous QA. Our work has demonstrated the importance of a continuous program of high quality We continue to strive for the adoptions of national standards of QA and our QA, has been recognised by two awards at prestigious meetings.
   
   i.) 2000 Best Paper Prize in Quality Assurance Section, Annual Scientific Meeting, Royal Australian and New Zealand College of Radiologists
   
   ii.) 2003 Best oral presentation, Australasian Brachytherapy Group Annual Scientific Meeting
   

The results of our audits have shown that the implants we perform are usually of a high quality and our outcomes of cancer control and side effects are in line with internationally published data.