• Hans Hawighorst, Gerd Becker, Norbert Hodapp, and Frederik Wenz.
• Landesärztekammer Baden-Württemberg, Stuttgart, Germany. hans.hawighorst@laek-bw.de
• Strahlenther Onkol. 2009 Aug 1; 185 (8): 493-9.

PurposeTo evaluate the structure quality (medical staff, linear accelerators, and patients) of radiotherapy units based on the clinical audits by the "Arztliche Stelle" (this institution is based on federal German law) in Baden-Württemberg.Material And MethodsExternal audits (performed by at least two radiation oncologists, one radiation physicist, and a member of the administration) of recently completed charts by designated reviewers using appropriate checklists developed by the federal task group ("Arztliche Stelle") were used.ResultsIn the interval from 2005 to 2007, 60 linear accelerators in 24 radiotherapy units served a population of approximately 10.7 million inhabitants (178,000 inhabitants/linear accelerator). 28,210 people with malignant tumors were treated in these units in 2007. These patients were served by 127 radiation oncologists, 83 radiation physicists, and 235 technologists. The ratio of patients irradiated annually to staff would become 222 (range 85-400) for a radiation oncologist, 339 for a radiation physicist (range 170-538), and 120 for a technologist (range 48-189). In five of seven departments (71%), new staff was employed following the recommendations of the auditors.ConclusionClinical audits by the "Arztliche Stelle" are highly effective to evaluate the structure quality of radiotherapy units. Based on these audits realistic data for staff requirements were gained. Making use of these data, guidelines for average minimum personnel necessary for good patient care were calculated. Personnel requirements may vary related to specific needs (teaching, research) of the treatment program and should be accounted for when discussing with the administration. The recommendations of the auditors of the "Arztliche Stelle" resulted in the new employment of additional staff.

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