目的：本文內容主要針對本科六年來執行每週病歷查核所發現的缺失予以分類、統計，並分析檢討其發生原因，尋求改善方法以降低錯誤率，進而提升醫療品質。材料與方法：依據美國醫學物理師學會放射治療委員會工作群40號報告(TG-40)，對於臨床治療品質保證計劃的建議，對於每位放射治療病患療程中，由劑量師與全體醫事放射師對其病歷實施每週一次的病歷查核。本研究自1999年1月起至2004年12月止共六年間，於每週一次實施病歷查核所發現的錯誤予以統計，並將其錯誤項目分類為劑量計算錯誤、填寫錯誤、治療師未簽名、執行誤差、總劑量加錯與其他類各項，並分析其發生原因，提出改善的對策，以期逐步減少人為因素的誤差。結果：在6年間共執行304次查核動作，共檢閱54418次病歷數，其中發現936次的錯誤，發生錯誤的比率為1.72%(936/54418)。屬於劑量計算錯誤佔0.56%(307/54418)、治療記錄項寫錯誤佔0.54%(292/54418)、治療師未簽名佔0.2%(110/54418)、執行誤差佔0.08%(46/54418)、總劑量加錯0.30%(165/54418)與其他各項佔0.03%(16/54418)。結論：每週病歷查核制度的實施可充分瞭解治療病歷記錄與治療執行的正確，並且可藉由錯誤數據探討其發生的原因並將錯誤即早加以改善與修正，進而提升放射治療部門醫療品質。

Purpose: The aim of this study was to classify, calculate and analyze the errors identified by weekly chart review during the past 6 years. Materials and Methods: According to the guidelines recommended by the Task Group-40 report, AAPM, and recommendation by clinical quality assurance protocol, a weekly chart review program was initiated by dosimetrists and radiation therapists for each patient receiving radiation therapy Patients and their charts seen and treated between January 1999 and December 2004 were routinely reviewed once every Thursday during their treatment course. Errors, once identified, were documented, and categorized as calculation, recording, no signature, execution, summation or others errors. We abs analyze the errors with documentation containing an explanation of the error as well as a plan to avoid errors of this type in the future. Results: A total of 54418 charts were reviewed by 304 chart checking execution during the past 6 years. Of these, 936 errors were identified, accounting for a incidence of 1.72% (936/54418). Of these, 0.56%(307/54418), 0.54%(292/54418), 0.2%(110/54418), 0.08%(46/54418), 0.30%(165/54418), 0.03%(16/54418) errors were due to calculation, recording, no signature, execution, summation and others respectively. Conclusion: A weekly chart review program can verify that all parameters are consistent from treatment plan to the daily treatment record to the treatment execution. A substantial proportion of treatment errors ca be effectively detected with aid of this program and thus weekly chart review program is an integrated part of quality assurance in a modem radiation oncology department.