RO-ILS Submit Event Data Elements

The purpose of the “Submit Event” page is for any user to perform initial, front-line reporting. This page includes less than 10 questions, listed below, and typically takes only a few minutes to complete. An asterisk symbol (*) indicates a required question.

Download a printable PDF of all RO-ILS data elements.

101. Location_Main

Question: *Location:
Response Option: The response option is specific to each contract (i.e., practice) and is autoselected
Branching Logic: None

102. Location_Sub

Question: *Sub Location:
Response Option: The response option(s) are specific to each contract (i.e., facility(ies))
Branching Logic: None

103. Location_Addt

Question: *Additional Location:
Response Option: The response options are optional and at the discretion of the practice
Branching Logic: None

104. Classification

Question: *Event Classification:
Response Option:

Therapeutic Radiation Incident: Radiation dose not delivered as intended, with or without harm
Other Safety Incident: Event that reached the patient, not involving radiation dose, with or without harm (examples: collision, fall, etc.)
Near-miss: A safety event that did not reach the patient
Unsafe condition: Any condition that increases the probability of a safety event
Operational/Process Improvement: non-safety event

Branching Logic: None

105. Narrative

Question: *Narrative: (Briefly describe the event, 4000 character limit)
Response Option: Free Text
Branching Logic: None

106. Tx_Technique

Question: *Treatment technique pertinent to event: (Select all that apply)
Response Option:

2-D
3-D
IMRT/VMAT
SRS/SBRT
Particles (Protons)
Electrons
Intraoperative
kV X-rays (i.e., Orthovoltage and superficial)
LDR
- List LDR radioisotope (manufacturer, if applicable) and applicator:
HDR
- List HDR radioisotope (manufacturer, if applicable) and applicator:
Radiopharmaceuticals
- List Radiopharmaceutical radioisotope (manufacturer, if applicable):
Total body irradiation (TBI)
Not Applicable
Other
- *Specify 'Other':

Branching Logic: None

107. Local_ID

Question: Local Identifier:
Response Option: Free Text
Branching Logic: None

108. Reporter_Name

Question: Reporter's Name:
Response Option: Free Text
Branching Logic: None

109. Event_Date_Time

Question: *Date and time the event occurred:
Response Option: MM/DD/YYYY, XX:XX AM/PM
Branching Logic: None

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