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.

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

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 Smoking Cessation at a Safety-Net Hospital: A Radiation Oncology Resident-Led Quality Improvement Initiative

2020 ◽  
Vol 5 (5) ◽  
pp. 1061-1065
Author(s):  
Stephen J. Ramey ◽  
Benjamin Silver ◽  
Dayssy A. Diaz ◽  
Akul Munjal ◽  
Shahil Mehta ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Quality Improvement ◽  
Radiation Oncology ◽  
Safety Net ◽  
Quality Improvement Initiative ◽  
Safety Net Hospital

scholarly journals Radiation oncology resident training in patient safety and quality improvement: a national survey of residency program directors

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Matthew B. Spraker ◽  
Matthew J. Nyflot ◽  
Kristi R. G. Hendrickson ◽  
Stephanie Terezakis ◽  
Shannon E. Fogh ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
National Survey ◽  
Residency Program ◽  
Radiation Oncology ◽  
Program Directors ◽  
Resident Training ◽  
Residency Program Directors

scholarly journals Quality Improvement Initiative to Improve Tobacco Cessation Efforts in Radiation Oncology

2019 ◽  
Vol 15 (4) ◽  
pp. e382-e388 ◽  
Author(s):  
Lisa Singer ◽  
Keith Sharee ◽  
Lauren Boreta ◽  
William R. Silveira ◽  
Steve Braunstein ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Quality Improvement ◽  
Electronic Health Record ◽  
Radiation Oncology ◽  
Tobacco Cessation ◽  
Quality Improvement Initiative ◽  
Health Record ◽  
Electronic Health ◽  
Readiness To Quit ◽  
Current Tobacco

PURPOSE: Although continued tobacco use in patients who are treated with radiation therapy is associated with inferior outcomes and increased treatment-related toxicity, multiple studies have shown that current tobacco cessation efforts in oncology are insufficient. A quality improvement (QI) initiative was developed with the goal of improving tobacco cessation efforts in radiation oncology. METHODS: Using iterative plan-do-study-act cycles, barriers to tobacco cessation were identified and then addressed with a single-institutional QI initiative designed to improve physician assessment of patient readiness to quit tobacco by 50% or more. Residents assessed readiness to quit tobacco during new patient consultations and recorded this assessment in prespecified fields within the electronic health record. Feedback on assessment efforts was provided to our department via an automated search of the electronic health record. RESULTS: From December 2014 to February 2015, before the initiation of the QI initiative, 4% of patients were assessed for their readiness to quit tobacco. After implementing the initiative, 67% of patients were assessed for their readiness to quit. CONCLUSION: After instituting a QI initiative at our institution, significantly more patients were assessed for readiness to quit tobacco before treatment with radiation therapy. Ongoing efforts in our department are aimed at improving the efficacy of this intervention.

Implementing pregnancy screening prior to chemotherapy: A quality improvement initiative.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18274-e18274
Author(s):  
Brittany Kayla Rogers ◽  
Andrew Kolarich ◽  
Merry Jennifer Markham
Keyword(s):  
Quality Improvement ◽  
Radiation Oncology ◽  
Medical Oncology ◽  
Point Of Care ◽  
Surgical Oncology ◽  
Tubal Ligation ◽  
Quality Improvement Initiative ◽  
Screening Rate ◽  
Childbearing Potential ◽  
Treatment Start

e18274 Background: ASCO’s QOPI sets standards for excellence in oncologic care. One standard is screening appropriate female patients for pregnancy prior to chemotherapy. No guidelines exist regarding screening protocols or timing. Prior data collection at our institution from 2012-2014 revealed that 35% of women of childbearing potential were screened prior to chemo, with medical oncology performing only 7% of screening. Less than half (48%) of those tests were ordered within 14 days prior to treatment start. Methods: A quality improvement (QI) intervention was implemented at UF Health outpatient infusion center on 8/15/16 based on the above data. A checkbox was added to the pre-chemo checklist used by infusion nurses. For eligible patients (women ages 18-55 without prior tubal ligation or hysterectomy), a point of care pregnancy test, included in standing orders, was recommended. We reviewed data for women who received outpatient chemo during 9/16-11/16 to determine rates of pregnancy screening (PS) after intervention. Results: 49 women, ages 18-55, of childbearing potential were identified and presented for 174 chemo cycles from 9/1/16 to 11/30/16. Of these, 15 (30.6%) received PS before chemo. Fifty pregnancy tests were ordered during this period; all were negative. Of the 50 tests, 42 (84%) were ordered by medical oncology, 3 (6%) by a surgical oncology, 3 (6%) by radiation oncology, and 1 (2%) by emergency medicine. Of the PS tests ordered by medical oncology, 64.2% were within 14 days of chemotherapy. Conclusions: In three months of QI intervention, PS prior to chemo increased from 7% to 30.6%. Screening was 13% in women older than 45, but higher in women age 25-34 (60%) and 35-44 (67%). Although the screening rate improved, it remains below our goal of 80%. Possible explanations for low rates are inclusion of postmenopausal women and those older than 50. Excluding these patients could reduce screening burden while identifying appropriate patients. [Table: see text]

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