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This letter proposes a framework based on high reliability organization (HRO) principles for managing real\u2010time, unforeseen events. The framework emphasizes proactive risk assessment, adaptive teamwork at the situation assessment point, and reactive learning through incident analysis by placing human\u2010centered decision\u2010making at the core. Integrating cognitive diversity, psychological safety, and emotional intelligence fosters collective intelligence, enabling teams to navigate AI\u2010driven complexities while safeguarding patient safety.<\/jats:p>","DOI":"10.1002\/acm2.70043","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T05:54:36Z","timestamp":1739858076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiation oncology at crossroads: Rise of AI and managing the unexpected"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0760-482X","authenticated-orcid":false,"given":"Mohammad","family":"Bakhtiari","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology WellSpan Health  Chambersburg Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2022.06.011"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110345"},{"volume-title":"Managing the Unexpected","year":"2001","author":"Weick KE","key":"e_1_2_7_4_1"},{"key":"e_1_2_7_5_1","article-title":"The two traits of the best problem\u2010solving teams","volume":"2","author":"Reynolds A","year":"2018","journal-title":"Harvard Business Review"},{"volume-title":"Emotional Intelligence: Why it Can Matter More Than IQ","year":"2020","author":"Goleman D","key":"e_1_2_7_6_1"},{"volume-title":"Superminds: The Surprising Power of People and Computers Thinking Together","year":"2018","author":"Malone TW","key":"e_1_2_7_7_1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4947547"},{"key":"e_1_2_7_9_1","unstructured":"PawlickiT et\u00a0al. 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