Peer review in radiotherapy (RT): A national quality improvement initiative.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 221-221 ◽  
Author(s):  
Michael Donald Brundage ◽  
Brenda H Bass ◽  
Sophie Foxcroft ◽  
Ross Halperin ◽  
Thomas McGowan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Peer Review ◽  
Quality Indicators ◽  
Radiation Oncology ◽  
Preliminary Evidence ◽  
Steering Committee ◽  
Perceived Barriers ◽  
Quality Improvement Initiative ◽  
Implementation Framework ◽  
National Quality

221 Background: Peer review (PR) in Radiation Oncology has been shown to be effective in improving quality of treatment by detecting and correcting deficiencies in proposed treatment plans prior to treatment. PR is also effective in: guiding departmental treatment planning policies and processes; reducing variation in practice; providing a venue for multi-disciplinary communication, and increasing staff and trainee awareness of evolving treatment processes. The importance of PR is reflected in the inclusion of 3 PR-specific quality indicators in the Canadian Partnership for Quality Radiotherapy QA Guidelines for Radiation Oncology programs. Given this endorsement, we aim to enhance PR implementation across all Canadian cancer centres using a knowledge-translation and implementation framework. Methods: This project will facilitate increased uptake of PR in Canadian RT programs by implementing the top-down model used with success in Ontario. This model has several key components, including: a) engaging the leadership of provincial cancer agencies to promote PR at every Provincial cancer centre; b) providing modest financial support for the acquisition of the required hardware and/or staff time for coordinating PR activities; c) systematic collection of each centre’s baseline PR activities, perceived barriers and potential facilitators of PR at each centre; d) creation of a continuous quality improvement cycle by monitoring PR quality indicators over time; e) systematic knowledge and information sharing regarding effective PR processes. Results: Funding for this initiative was obtained from the Canadian Partnership against Cancer (CPAC) in April 2014. A steering committee consisting of stakeholders from across Canada has been struck and provincial launches, based on the tenets used in Ontario, have commenced in 7 of 13 provinces with others expressing interest. A national survey to obtain baseline data relating to PR activities, perceived barriers, and facilitators is underway and will be reported. Conclusions: Preliminary evidence suggests a “snowball effect” of increasing PR uptake across Canada. The implementation model could be applied in other jurisdictions interested in increasing PR in radiation oncology.

scholarly journals Adverse events in radiation oncology: A case series from wake up safe, the pediatric anesthesia quality improvement initiative

2019 ◽  
Vol 29 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Robert E. Christensen ◽  
Rebecca C. Nause-Osthoff ◽  
Jeffrey C. Waldman ◽  
Daniel E. Spratt ◽  
Jason W. D. Hearn
Keyword(s):  
Quality Improvement ◽  
Adverse Events ◽  
Radiation Oncology ◽  
Pediatric Anesthesia ◽  
Case Series ◽  
Quality Improvement Initiative

scholarly journals Monitoring of older HIV‐1‐positive adults by HIV clinics in the United Kingdom: a national quality improvement initiative

HIV Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 409-417
Author(s):  
N Ekong ◽  
H Curtis ◽  
E Ong ◽  
CA Sabin ◽  
D Chadwick ◽  
...  
Keyword(s):  
United Kingdom ◽  
Quality Improvement ◽  
Quality Improvement Initiative ◽  
The United Kingdom ◽  
National Quality ◽  
Hiv 1

Databases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease – the perspective of cardiology

2008 ◽  
Vol 18 (S2) ◽  
pp. 116-123 ◽  
Author(s):  
Kathy J. Jenkins ◽  
Robert H. Beekman III ◽  
Lisa J. Bergersen ◽  
Allen D. Everett ◽  
Thomas J. Forbes ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cardiac Disease ◽  
Interventional Cardiology ◽  
National Database ◽  
Quality Improvement Initiative ◽  
Paediatric Cardiology ◽  
Data Registry ◽  
National Quality ◽  
Adult Congenital ◽  
The Impact

AbstractThis review includes a brief discussion, from the perspective of the pediatric cardiologist, of the rationale for creation and maintenance of multi-institutional databases of outcomes of the treatment of patients with congenital and paediatric cardiac disease, together with a history of the evolution of such databases, and a description of the current state of the art. A number of projects designed to have broad-based impact are currently in the design phase, or have already been implemented. Not surprisingly, most of the efforts thus far have focused on catheterization procedures and interventions, although some work examining other aspects of paediatric cardiology practice is also beginning. This review briefly describes several European and North American initiatives related to databases for pediatric and congenital cardiology including the Central Cardiac Audit Database of the United Kingdom, national database initiatives for pediatric cardiology in Switzerland and Germany, various database initiatives under the leadership of the Working Groups of The Association for European Paediatric Cardiology, the IMPACT Registry™ (IMproving Pediatric and Adult Congenital Treatment) of the National Cardiovascular Data Registry® of The American College of Cardiology Foundation® and The Society for Cardiovascular Angiography and Interventions (SCAI), the Mid-Atlantic Group of Interventional Cardiology (MAGIC) Catheterization Outcomes Project, the Congenital Cardiac Catheterization Project on Outcomes (C3PO), the Congenital Cardiovascular Interventional Study Consortium (CCISC), and the Joint Council on Congenital Heart Disease (JCCHD) National Quality Improvement Initiative. These projects, each leveraging multicentre data and collaboration, demonstrate the enormous progress that has occurred over the last several years to improve the quality and consistency of information about nonsurgical treatment for congenital cardiac disease. The paediatric cardiology field is well-poised to move quickly beyond outcome assessment and benchmarking, to collaborative quality improvement.

Abstract 177: National Trends in Inpatient Stroke Quality: VHA Experience

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Linda S Williams ◽  
Teresa Damush ◽  
James Slavin ◽  
Zhangsheng Yu ◽  
Danielle Sager ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Indicators ◽  
Randomized Study ◽  
Stroke Care ◽  
Fiscal Year ◽  
Smoking Cessation Counseling ◽  
Chi Square ◽  
Passing Rates ◽  
National Quality ◽  
Student’S T

Objectives: In 2009, the VHA reported inpatient stroke quality indicators based on chart abstractions of fiscal year (FY) 2007 data at all VA medical centers (VAMCs). Prior to a randomized trial of a Systems Redesign-based intervention, we re-measured VA stroke quality indicators (QIs) from 2009 data in 11 of the largest volume VAMCs. The purpose of this analysis is to examine whether any significant changes occurred in inpatient stroke care in these sites between 2007 and 2009. Methods: Data for 10 Joint Commission (JC) inpatient stroke QIs were obtained by experienced external VA chart abstractors via review of FY 2007 electronic medical records. We abstracted 2009 data at 11 sites as baseline data for a quality improvement randomized study. We calculated eligibility and passing rates for ten inpatient stroke QIs defined similarly to the 10 JC indicators from the FY 2007 study. We compared patient demographics, clinical variables, and passing rates for each QI between the FY 2007 and CY 2009 data at the 11 sites using Student’s t-test and Chi-square tests. Results: Comparing 2007 (N =750) to 2009 (N =817) data, mean age (66.3, 66.6), % male (97%, 96%), and % Black (34%, 33%) were similar but mean NIH Stroke Scale score was increased in 2009 (4.2, 5.9, p < 0.001). Three QIs were unchanged over time: DVT prophylaxis, anticoagulation for atrial fibrillation, and antithrombotic at discharge (Table). Performance on four indicators was significantly improved: dysphagia screening (16%, 45%), receipt of rehabilitation consultation (62%, 89%), stroke education (17%, 31%), and receipt of tPA (17%, 47%). Performance on three indicators was significantly reduced: antithrombotic by hospital day two (98%, 87%), cholesterol lowering medication at discharge (90%, 72%), and receipt of smoking cessation counseling (100%, 89%). Conclusions: Prior to VHA national quality improvement efforts, both positive and negative shifts in performance occurred for common inpatient stroke QIs. Future work should examine whether focusing efforts on one aspect of stroke care can lead to reduction in quality in other areas, and on whether consistent reporting of these QIs can promote maintenance of high quality stroke care across a large national healthcare system.

scholarly journals Implementing Integrated Mental Health and Chaplain Care in a National Quality Improvement Initiative

2017 ◽  
Vol 68 (12) ◽  
pp. 1213-1215 ◽  
Author(s):  
Jason A. Nieuwsma ◽  
Heather A. King ◽  
George L. Jackson ◽  
Balmatee Bidassie ◽  
Laura W. Wright ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Quality Improvement Initiative ◽  
National Quality ◽  
Integrated Mental Health

scholarly journals Remote Contouring and Virtual Review during the COVID-19 Pandemic (RECOVR-COVID19): Results of a Quality Improvement Initiative for Virtual Resident Training in Radiation Oncology

2021 ◽  
Vol 28 (4) ◽  
pp. 2961-2968
Author(s):  
Andrew J. Arifin ◽  
Rohann J. M. Correa ◽  
Christopher D. Goodman ◽  
Joanna Laba ◽  
Robert E. Dinniwell ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Radiation Oncology ◽  
Learning Opportunities ◽  
Resident Training ◽  
Quality Improvement Initiative ◽  
Immediate Feedback ◽  
Educational Value ◽  
Competency Based Medical Education ◽  
Competency Based ◽  
Post Hoc

The need to minimize in-person interactions during the COVID-19 pandemic has led to fewer clinical learning opportunities for trainees. With ongoing utilization of virtual platforms for resident education, efforts to maximize their value are essential. Herein we describe a resident-led quality improvement initiative to optimize remote contouring and virtual contour review. From April to June 2020, radiation oncology (RO) residents at our institution were assigned modified duties. We implemented a program to source and assign cases to residents for remote contouring and to promote and optimize virtual contour review. Resident-perceived educational value was prospectively collected and analyzed. All nine RO residents at our institution (PGY1–5) participated, and 97 cases were contoured during the evaluation period. Introduction of the Remote Contouring and Virtual Review (RECOVR) program coincided with a significant increase in mean cases contoured per week, from 5.5 to 17.3 (p = 0.015), and an increased proportion of cases receiving virtual review, from 14.8% to 58.6% (p < 0.001). Residents reported that the value of immediate feedback during virtual review was similar to that of in-person review (4.6 ± 0.1 vs. 4.5 ± 0.2, p = 0.803) and significantly higher than feedback received post hoc (e.g., email; 3.6 ± 0.2, p < 0.001). The implementation of a remote process for contour review led to significant increases in contouring, and virtual contour review was rated as highly as in-person interactions. Our findings provide a data-driven rationale and framework for integrating remote contouring and virtual review into competency-based medical education.

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