目的:本文內容主要針對每週病歷查核所發現缺失予以分類、統計分析其發生原因，並介紹本科執行每週病歷查核制度的方法及經驗。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(TG-40)的報告，對臨床治療品質保證計劃的建議，於每一位病患治療療程中，對其病歷實施每週一次的病歷查核。本文共記錄自1998年7月起到1999年6月止一年間，於每週五實施病歷查核所發現的誤差，對於所發現缺失分類為劑量計算錯誤、治療記錄填寫錯誤、治療設定錯誤或其他錯誤，同時也分析錯誤的發生和治療機器、治療時段之關係，此外對於劑量執行誤差的病歷，依誤差程度統計並分析發生原因。結果:在共9425本次數的病歷查核中發現172本有錯誤的病歷，發生錯誤比率為1.8%(172/9425)。其中屬於劑量計算錯誤占45.3%(78/172)及治療記錄填寫錯誤為52.3%(90/172)，而治療設定錯誤或其他錯誤占2.4%(4/172)。在所有劑量執行誤差的病歷中，單次執行劑量與處方劑量誤差率小於或等於5%者占大多數78%(64/82);而就所發現錯誤在各治療機器分布情形，L4占28.5%(49/172)，L1及L2各占23.8%(41/172)，L3為16.9%(29/172)，L5占7%(12/172);從所發現錯誤病歷在各治療時間分布上，最高者為下午3至4點，占所有錯誤病歷20%(34/172)。結論:每週病歷查核制度的實施為放射治療部門品質保證計劃不可忽視的重要課題，可藉此發現治療錯誤，並儘早更正。

　　　　　Purpose: To initiate and conduct a weekly chart review program in a radiation oncologydepartment. Its results were analyzed and reported.Methods and Materials: According to the guidelines recommended by the Task Group-40 report,AAPM, a weekly chart review program was initiated. Patients and their charts seen and treatedbetween June 1998 and July 1999 were routinely reviewed once every Friday during their treatmentcourse. Errors, once identified, were documented, and categorized as calculation (summation),recording, or execution errors. Analyses were also made according to treatment machines and timeallocations. Calculation errors were rated according to the discrepancy between the dose actuallydelivered and prescribed.Results: A total of 9425 charts were reviewed. Of these, 172 errors were identified, accounting foran incidence of 1.8% (172/9425). Of these, 45.3% (78/172), 52.3% (90/172), 2.4% (4/172) errorswere due to calculation, recording, and execution, respectively. Dose discrepancy in 78% ofpatients was less than or equal to 5%. Error distributions by treatment machine were 23.8%, 23.8%,16.9%, 28.5%, and 7%, for L1 through L5, respectively. The most frequent time allocation thaterrors occurred was 3-4 PM, accounting for 20% of total errors.Conclusion: A weekly chart review program is an integrated part of quality assurance in a modemradiation oncology department. A substantial proportion of treatment errors can be effectivelydetected with aid of this program.