RO-ILS Enrollment

ASTRO is committed to supporting patient safety through various initiatives, with the primary tools being RO-ILS: Radiation Oncology Incident Learning System^®. RO-ILS empowers practice staff by fostering a culture of safety, enabling them to report and analyze incidents without fear of blame, and driving continuous improvement through shared learning.

All U.S.-based radiation oncology practices are encouraged to enroll in RO-ILS, regardless of practice size, setting or organizational arrangement. There is no fee to enroll or participate in RO-ILS. Enrollment is an easy process organized into three distinct stages: contracting, onboarding and implementation. The following diagram summarizes the required enrollment tasks with further details below.

Contracting

Clarity PSO is one of the earliest patient safety organizations (PSOs) listed by AHRQ to aggregate safety data into a protected database. The Patient Safety Act requires that practices contract with a PSO to establish the confidentiality and privilege protections afforded by the federal law. To enroll in RO-ILS, practices must complete the following steps:

1. Download and review the RO-ILS Participation Guide.
2. Complete and submit the Enrollment Form.
   • The form collects practice information, its associated facilities and key contacts. Information can be updated or added during the enrollment process and while participating, as needed.
   • Practices submit the completed form to Clarity PSO at [email protected] to initiate the formal contracting process.
3. Sign Agreements with Clarity PSO.
   • After processing the enrollment form, Clarity PSO sends a copy of the contract to the key contacts. A sample of the PSO Provider Services Agreement is available for review.
     • Practices can participate in more than one PSO. For example, if a hospital-based system is already engaged with another PSO for general hospital error reporting, the practice can still enroll in RO-ILS.
   • Practices enter into a Business Associate Agreement (BAA) with Clarity PSO. RO-ILS does not require identifying patient or provider information; however, a BAA meets HIPAA requirements in case any protected health information is entered into RO-ILS.
   • Contact Clarity PSO at [email protected] or 773-864-8280 for specific questions regarding agreements.

Onboarding

Key contacts/staff designated on the Enrollment Form complete the onboarding stage:

1. Orientation: Staff receive an introduction to the program, with a focus on understanding the process for submitting and reviewing an event.
2. Workflow: Staff determine their internal workflow, specify internal Reviewers, and provide practice-specific information for the Portal. They will also receive the practice’s unique access information for the RO-ILS Portal and Reviewers receive unique login credentials.
3. Data protections education: Staff watch training videos that explain the confidentiality and privileged protections of data. With guidance, the practice develops their internal patient safety evaluation system policy to document the processes associated with data protection. 

The onboarding process includes on-demand training videos, program documents and sample resources to allow the practice to move at their desired pace. Clarity staff will check in throughout and are available for support.

Implementation

During the last enrollment phase, the practice deploys RO-ILS to all staff and initiates the internal processes developed or updated during onboarding. Implementing a new system can be daunting, especially for busy practice staff. To help alleviate the burden, resources such as sample implementation plans, PowerPoint presentations and staff support are available. Successful implementation is essential for staff engagement, so practices should proactively encourage reporting of safety events (both actual incidents and potential errors) to facilitate participation.

Throughout deployment, key staff should emphasize safety culture and actively foster a supportive, non-hierarchical, and psychologically safe work environment. For practices without a history of positive event reporting, initial implementation may be difficult as initial responses from staff may result from a lack of trust or fear of punitive action. There is no magical mechanism by which trust is developed so be thoughtful in every interaction and with time, confidence in the quality and safety intentions will develop.

Once enrolled in the program, practices can participate in RO-ILS and gain the associated benefits. The RO-ILS Participation webpage includes the event workflow, topics that impact participation and ideas on how to promote engagement.

For support or to learn more, please email the RO-ILS staff.