Communities of practice: A jurisdictional approach to improving the quality of care in radiation medicine in Ontario.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 122-122
Author(s):  
Elizabeth Lockhart ◽  
Michelle Ang ◽  
Lindsay Elizabeth Reddeman ◽  
Michael Sharpe ◽  
Margaret Hart ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Quality Of Care ◽  
Knowledge Transfer ◽  
Best Practices ◽  
Communities Of Practice ◽  
Radiation Treatment ◽  
Medical Physics ◽  
Quality And Safety ◽  
Radiation Medicine

122 Background: The Radiation Treatment Program (RTP) at Cancer Care Ontario (CCO) established several Communities of Practice (CoPs), with the goal of improving radiation treatment (RT) quality and safety. The RTP identifies variation in practice and quality improvement (QI) opportunities in the 14 Regional Cancer Centres (RCCs) and facilitates the development of CoPs to share best practices and standardize care. Methods: Since 2010, the RTP has formed 7 CoPs ( > 185 members in total): 4 intra-disciplinary (Radiation Therapy, Medical Physics, Advanced Practice Radiation Therapy, Radiation Safety) and 3 inter-disciplinary (Head and Neck (HN), Gynecological (GYNE) and Lung Cancer). Members are recruited with the aim of securing engagement from all RCCs to ensure representation of regional diversity and to facilitate adoption of best practices. CoPs are supported with nominal funding and resources provided by CCO, but are led and driven by members, who identify and prioritize key quality issues and select corresponding QI projects to pursue. The RTP performs regular evaluation activities to assess initiative engagement and impact. Results: RTP CoPs have enhanced the quality and safety of RT delivery in Ontario through QI initiatives, advice documents and tools that have enabled: Improved RT safety (use of safety straps in RT delivery); Adoption of best practices (RT plan evaluation guidance); Education and knowledge transfer – (stereotactic body RT implementation and training framework); and Support for infrastructure improvements (recommendation for additional Magnetic Resonance-guided brachytherapy units) ( https://www.cancercare.on.ca/ocs/clinicalprogs/radiationtreatment/ ). Advice documents have improved alignment with recommended practice (40% and 50% absolute increases in two HN initiatives). Evaluation surveys indicate that members believe the CoPs have enhanced inter-regional communication and collaboration (89%), knowledge transfer/exchange (91%), and professional networking between RCCs (92%). Conclusions: CoPs can be a highly effective model for improving quality of care. The establishment of CoPs should be considered for QI in other areas of the healthcare system.

A new model of care: An advanced practice radiation therapy role.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 131-131
Author(s):  
Elizabeth Lockhart ◽  
Eric Gutierrez ◽  
Padraig Richard Warde ◽  
Kate Bak ◽  
Laura Zychla ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Quality Of Care ◽  
Resource Constraints ◽  
Models Of Care ◽  
Advanced Practice ◽  
Term Care ◽  
Implementation Phase ◽  
National Implementation ◽  
Radiation Medicine

131 Background: Due to the rising incidence of cancer, increasing complexity of cancer treatment and growing resource constraints, there is demand for innovative interprofessional models of care. Cancer Care Ontario (CCO), in collaboration with Ontario’s Ministry of Health and Long-Term Care, launched the Clinical Specialist Radiation Therapist (CSRT) project to investigate a new advanced practice (AP) radiation therapy (RT) role. Methods: A series of pilot phases commenced in 2004. A system wide implementation phase began in 2010. The overall goal of the project was to enable CSRTs to assume responsibility for certain key radiation medicine activities, optimize RT team functioning, and improve quality of care. This was to be achieved by applying advanced clinical, technical and professional RT competencies. A project team coordinated assessment of new position proposals, implementation activities, and data collection. Work towards formalizing the role is being conducted through partnerships with cancer centre administrations and the national professional association for RTs. Results: Currently there are 17 CSRTs in 6 of 14 Ontario cancer centres, practicing in palliative and disease-site specific positions. The provincial total will be 24 CSRTs in 10 centres by Fall 2014. Data show a major impact on patient throughput and wait times, with significant increased capacity in some clinics. CSRTs’ impact within their departments is being evaluated with regards to: 1) capacity building, 2) quality of care, and 3) knowledge translation (KT). In terms of role formalization, 6 positions are now considered permanent within their centres and the first iteration of a national certification process is anticipated for fall 2014. Conclusions: The CSRT project is aligned with CCO's priorities of improving Ontario’s cancer system performance by implementing innovative models of care and providing high quality care. This jurisdictional implementation project has demonstrated that an AP RT role can be successful in addressing system pressures and improving quality of care and innovation in Radiation Medicine. Further work is necessary to develop and formalize this AP role and leverage learnings for national implementation and future models of care work.

scholarly journals Communities of Practice: Creating Opportunities to Enhance Quality of Care and Safe Practices

2008 ◽  
Vol 11 (sp) ◽  
pp. 80-84 ◽  
Author(s):  
Debbie White ◽  
Esther Suter ◽  
I. Parboosingh ◽  
Elizabeth Taylor
Keyword(s):  
Quality Of Care ◽  
Communities Of Practice ◽  
Safe Practices

scholarly journals Prevention and correction of radiation dermatitis with basic skin care: doctor and patient consensus

2021 ◽  
pp. 167-172
Author(s):  
D. A. Khlanta ◽  
D. S. Romanov
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Radiation Treatment ◽  
Negative Impact ◽  
Clinical Manifestations ◽  
External Beam Radiation ◽  
Radiation Dermatitis ◽  
Beam Radiation ◽  
Post Radiation

External beam radiation therapy is widely used by doctors around the world as one of the most common form of cancer treatment. The radiotherapy can help reduce the treatment aggression as compared with the surgical intervention in a large number of clinical situations, which ensures that the patient's quality of life will be decreased to a lesser extent in the after-treatment period. However, like the vast majority of anticancer treatments, the radiation therapy has a number of side effects, which are classified into acute radiation reactions and post-radiation injuries. Among them is radiation dermatitis, which is one of the most common adverse reactions to the radiotherapy. This complication manifests as erythema, as well as hyperpigmentation, dry and itchy skin, hair loss. In addition to the obvious negative impact on the patient's quality of life, some of the above factors can result in the development of a secondary skin infection. As one of the most frequent post-radiation complications, radiation dermatitis places radiotherapists before a challenge to reduce the incidence rates of this side effect, as well as to decrease the intensity of its clinical manifestations if it occurs. This challenge suggests the search for targeted drugs aimed to prevent and treat clinical symptoms. To date, dermatocosmetic products that are used to relieve skin manifestations of radiation treatment complications is an alternate option of the effective solution to the problem of radiation dermatitis. In the described clinical case, we assess the experience of using some of the dermatocosmetic products in a patient with a florid form of radiation dermatitis. 

scholarly journals Techniques to Analyze the Effects of Radiation Therapy on Enamel and Dentin - A Review

2016 ◽  
Vol 06 (04) ◽  
pp. 71-78
Author(s):  
Mithra N. Hegde ◽  
Nidharsh D. Hegde ◽  
Suchetha Kumari N. ◽  
Ganesh Sanjeev ◽  
Priya G. ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Treatment ◽  
Positive Outcome ◽  
Effective Rate ◽  
Review Article ◽  
Morphological Properties ◽  
Common Source ◽  
Radiation Caries ◽  
Effects Of Radiation

AbstractRadiation therapy is a most common source in the treatment of Head and neck cancers. The therapy has a positive outcome in curing patients out of danger at an effective rate. But there are few major and minor side effects of the treatment which will possibly hinder the quality of life. One such major concern followed with the therapy is Radiation related caries. Radiation is known to damage the tissues of the teeth making it more susceptible for caries. Hence this review article details on techniques that is being used to test the mechanical and morphological properties of the teeth. The changes observed in these tissues after radiation treatment will enable us to understand the causes for caries. therefore further research in this field is necessary to develop strategies that will probably prevent radiation caries in future days.

scholarly journals The role of boards in clinical governance: activities and attitudes among members of public health service boards in Victoria

2013 ◽  
Vol 37 (5) ◽  
pp. 682 ◽  
Author(s):  
Marie M. Bismark ◽  
Simon J. Walter ◽  
David M. Studdert
Keyword(s):  
Public Health ◽  
Quality Of Care ◽  
Health Service ◽  
Health Services ◽  
Public Health Service ◽  
Clinical Governance ◽  
Board Members ◽  
Quality And Safety ◽  
Quality Performance

Objectives To determine the nature and extent of governance activities by health service boards in relation to quality and safety of care and to gauge the expertise and perspectives of board members in this area. Methods This study used an online and postal survey of the Board Chair, Quality Committee Chair and two randomly selected members from the boards of all 85 health services in Victoria. Seventy percent (233/332) of members surveyed responded and 96% (82/85) of boards had at least one member respond. Results Most boards had quality performance as a standing item on meeting agendas (79%) and reviewed data on medication errors and hospital-acquired infections at least quarterly (77%). Fewer boards benchmarked their service’s quality performance against external comparators (50%) or offered board members formal training on quality (53%). Eighty-two percent of board members identified quality as a top priority for board oversight, yet members generally considered their boards to be a relatively minor force in shaping the quality of care. There was a positive correlation between the size of health services (total budget, inpatient separations) and their board’s level of engagement in quality-related activities. Ninety percent of board members indicated that additional training in quality and safety would be ‘moderately useful’ or ‘very useful’. Almost every respondent believed the overall quality of care their service delivered was as good as, or better than, the typical Victorian health service. Conclusions Collectively, health service boards are engaged in an impressive range of clinical governance activities. However, the extent of engagement is uneven across boards, certain knowledge deficits are evident and there was wide agreement among board members that further training in quality-related issues would be useful. What is known about the topic? There is an emerging international consensus that effective board leadership is a vital element of high-quality healthcare. In Australia, new National Health Standards require all public health service boards to have a ‘system of governance that actively manages patient safety and quality risks’. What does this paper add? Our survey of all public health service Boards in Victoria found that, overall, boards are engaged in an impressive range of clinical governance activities. However, tensions are evident. First, whereas some boards are strongly engaged in clinical governance, others report relatively little activity. Second, despite 8 in 10 members rating quality as a top board priority, few members regarded boards as influential players in determining it. Third, although members regarded their boards as having strong expertise in quality, there were signs of knowledge limitations, including: near consensus that (additional) training would be useful; unfamiliarity with key national quality documents; and overly optimistic beliefs about quality performance. What are the implications for practitioners? There is scope to improve board expertise in clinical governance through tailored training programs. Better board reporting would help to address the concern of some board members that they are drowning in data yet thirsty for meaningful information. Finally, standardised frameworks for benchmarking internal quality data against external measures would help boards to assess the performance of their own health service and identify opportunities for improvement.

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