scholarly journals Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent

2018 ◽  
Vol 14 (12) ◽  
pp. e794-e800
Author(s):  
Dina Thompson ◽  
Kimberly Cox ◽  
James Loudon ◽  
Ivan Yeung ◽  
Woodrow Wells
Keyword(s):  
Peer Review ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Palliative Intent ◽  
Treatment Plans ◽  
Important Quality ◽  
Radiation Medicine ◽  
Radiotherapy Treatment

Purpose: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. Methods and Materials: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review. Results: Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically. Conclusion: Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.

An Android-Enabled PHR-based System for the Provision of Homecare Services

2013 ◽  
Vol 3 (2) ◽  
pp. 1-18 ◽  
Author(s):  
Vassiliki Koufi ◽  
Flora Malamateniou ◽  
George Vassilacopoulos
Keyword(s):  
Healthcare Professionals ◽  
Point Of Care ◽  
Treatment Plan ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Appropriate Treatment ◽  
Treatment Plans ◽  
The Continuum

Homecare is an important component of the continuum of care as it provides the potential to improve quality of life and quality of healthcare delivery while containing costs. Personal Health Record (PHR) systems are intended to reach patients outside of care settings and influence their behaviors thus allowing for more effective homecare services. To this end, these systems need to evolve well beyond providing a consolidated patient record, in ways that make it more widely applicable and valuable to health systems. The development of applications on top of PHR systems can allow them to function as a platform for both patients and healthcare professionals to exchange information and interact with the health system. This paper presents a prototype PHR-based system that aims at supporting chronic disease management at any point of care or decision making through familiar environments such as Google’s Android. In particular, it assists healthcare professionals in assessing an individual’s condition and in forming the appropriate treatment plan for him/her while it provides individuals with step-to-step guidance to their treatment plans.

Toward quality peer review: Outcomes of peer review across provincial radiation oncology programs.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 205-205
Author(s):  
Julie Rouette ◽  
Jennifer O'Donnell ◽  
Sophie Foxcroft ◽  
Margaret Hart ◽  
Eric Gutierrez ◽  
...  
Keyword(s):  
Peer Review ◽  
Radiation Oncology ◽  
Left Breast ◽  
Activity Level ◽  
Curative Treatment ◽  
Disease Site ◽  
Treatment Plans ◽  
Important Quality ◽  
Bilateral Lung ◽  
Treatment Intent

205 Background: Review of treatment plans by a second radiation oncologist is an important quality indicator in radiation oncology. Peer review (PR) can improve quality of care in individual patients by detecting clinical and planning issues and recommending plan changes. This study reports the frequency and nature of these changes across all 14 radiation oncology programs (ROPs) in Ontario, Canada. Methods: We identified all peer-reviewed curative treatment plans delivered in Ontario within a 3-month study period between Dec 2013-Nov 2014 using Cancer Care Ontario’s Activity Level Reporting System, where data on treatment intent and date, disease site treated, PR status, timing of PR, and nature of recommended changes were available. Results: There was considerable variation in the proportion of plans peer-reviewed across ROPs (70.2%, range: 40.8-99.2%). Over the study period, 5,561 curative treatment plans were peer-reviewed and 3.3% had changes recommended. Of those, 21.0% had major clinical and re-planning implications. Recommended changes most often involved minor (63.1%) vs major (36.9%) re-planning implications. Highest proportions of changes were recommended for the treatment of the esophagus, uterus, upper limb, cervix, lower limb, H&N, bilateral lung, right supraclavicular nodes, rectum, and spine (5.0%-7.0%). Plans involving the left breast had slightly more changes recommended (3.0% [95%CI:2.0%-4.5%]) vs right breast (2.4% [95%CI:1.5%-3.8%]). Recommendations were more frequently made when PR was conducted pre-radiotherapy (3.8%) vs during (1.4%-2.8%; p = 0.005), however the nature and implementation of changes were not statistically associated with the timing of PR (p = 0.91; p = 0.23, respectively). Proportion of recommended changes to treatment plans was not statistically associated with ROP patient volume (p = 0.08), proportion of plans peer-reviewed (p = 0.36) or academic status (p = 0.75). Conclusions: Significant variation exists in the proportion of recommended changes across all disease sites and ROPs. PR seems effective in detecting treatment plans with important clinical and planning issues; strategies should be developed to optimize its conduct in radiation oncology.

Physician-Predicted Prognosis and Palliative Radiotherapy Treatment Utilization at the End of Life: An Audit of a Large Cancer Center Network

2020 ◽  
Vol 60 (5) ◽  
pp. 898-905.e7
Author(s):  
Adrianna E. Mojica-Márquez ◽  
Joshua L. Rodríguez-López ◽  
Ankur K. Patel ◽  
Diane C. Ling ◽  
Malolan S. Rajagopalan ◽  
...  
Keyword(s):  
End Of Life ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Treatment Utilization ◽  
Radiotherapy Treatment

Adoption of a regional physician peer review program for radiation oncology.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 67-67
Author(s):  
Eleanor Elizabeth Harris ◽  
Hyder Husain Arastu ◽  
Clinton Leinweber ◽  
Andrew Ju ◽  
Robert McLaurin ◽  
...  
Keyword(s):  
Peer Review ◽  
Radiation Oncology ◽  
Department Chair ◽  
Peer Group ◽  
Major Change ◽  
White Paper ◽  
Telemedicine System ◽  
Treatment Plans ◽  
Improvement Programs

67 Background: Physician peer review is an important component of patient quality and safety programs. In 2012, the American Society for Radiation Oncology (ASTRO) published a white paper on peer review standards with recommendations to evaluate quality standards and compliance. Methods: Per ASTRO guidelines, physician peer review policy was adopted in 2013 by the Radiation Oncologists at the medical school and health system regional network. Peer review was conducted via WebEx by 5 regional centers. Reviews were done prior to start of treatment for all but emergent cases. Data were collected prospectively on 25 quality metrics, and scored by pre-defined peer consensus as follows: no change, minor change, major change, refer to chair. A description of recommended change was notated. Major changes were required to be represented. Aggregate data for the group and per physician were analyzed quarterly and incorporated into annual performance evaluations. Results: Aggregate categorical scores were compared for time periods from June to December 2014 (N = 283 cases) and June to December 2015 (N = 352 cases), showing an overall improvement in average scores per physician from 1.150 to 1.001. There were 56 (19.7%) total variances in 2014 compared to 32 (9%) variances in 2015. Level 2 changes (“minor”) decreased from 15.5% in 2014 to 7.2% in 2015 (p = 0.001). Level 3 changes (“major”) decreased from 4.2% to 1.9%, respectively (NS). The most common minor and major changes recommended related to dose parameters and target volumes. Variance rates over 5% were addressed by the department chair with individual practitioners and improvement programs instituted as needed. Conclusions: Peer review among a geographically diffuse physician group including an academic group practice and solo community physicians was feasible using a telemedicine system. Acceptance by the peer group was high, and over time the conference was increasingly used by physicians to review cases prior to initiating treatment planning, resulting in overall improved quality of treatment plans presented. Improved quality of care for radiation patients’ was demonstrated by significant reductions in the number and severity level of changes to treatment plans recommended.

PO-1798: Quality of radiotherapy treatment plans for locally advanced sinonasal tumors in a phase II trial

2020 ◽  
Vol 152 ◽  
pp. S1003-S1004
Author(s):  
B. Vischioni ◽  
A. Mirandola ◽  
M. Bonora ◽  
S. Ronchi ◽  
E. Mastella ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Trial ◽  
Locally Advanced ◽  
Treatment Plans ◽  
Radiotherapy Treatment

Is having a job a protective factor? Employment status and state of medical care as subjectively perceived by adults with CHD in Germany

2016 ◽  
Vol 27 (6) ◽  
pp. 1110-1117 ◽  
Author(s):  
Paul C. Helm ◽  
Elisabeth J. Sticker ◽  
Roland Keuchen ◽  
Marc-André Koerten ◽  
Gerhard-Paul Diller ◽  
...  
Keyword(s):  
Medical Care ◽  
Employment Status ◽  
Online Survey ◽  
Protective Factor ◽  
Heart Defects ◽  
Treatment Plan ◽  
Individual Treatment ◽  
Patient Organisations ◽  
Treatment Plans

AbstractBackgroundMost patients born with CHD nowadays reach adulthood, and thus quality of life, life situation, and state of medical care aspects are gaining importance in the current era. The present study aimed to investigate whether patients’ assessment depends on their means of occupation. The findings are expected to be helpful in optimising care and for developing individual treatment plans.MethodsThe present study was based on an online survey conducted in cooperation with patient organisations. Participants were recruited from the database of the German National Register for Congenital Heart Defects. In total, 1828 individuals (777 males, 1051 females) took part. Participants were asked to rate aspects such their state of health on a six-tier scale (1=worst specification). Response behaviour was measured against the background of occupational details.ResultsTraining for or pursuing a profession was found to be significantly associated with participants’ rating of five of the six examined aspects (p<0.05). Sex seemed to play an important part in four of the six aspects.ConclusionsAn optimal treatment plan for adults with CHD should always consider aspects such as sex and employment status. To work out such an optimal and individual treatment plan for each adult CHD patient, an objective tool to measure patients’ actual CHD-specific knowledge precluding socially accepted response bias would be very useful.

“I sleep better at night:” How peer review of radiation treatment plans indirectly improves quality of care across radiation treatment programs

2017 ◽  
Vol 7 (4) ◽  
pp. 281-288 ◽  
Author(s):  
Michael D. Brundage ◽  
Margaret Hart ◽  
Jennifer O’Donnell ◽  
Lindsay Reddeman ◽  
Eric Gutierrez ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Peer Review ◽  
Radiation Treatment ◽  
Treatment Programs ◽  
Treatment Plans
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