Patient Safety

PV QA 3 - Poster Viewing Q&A 3

TU_26_3064 - Quantitative Metric and Automatic Auditing Program (QMAP) Can be Applied to Regional Sites to Improve Quality and Consistency

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Quantitative Metric and Automatic Auditing Program (QMAP) Can be Applied to Regional Sites to Improve Quality and Consistency
N. Yu1, D. LaHurd2, J. H. Suh3, and P. Xia1; 1Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 2Department of Radiation Oncology, Taussiq Cancer Center, Cleveland Clinic, Cleveland, OH, 3Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH

Purpose/Objective(s): Timely completion of each critical clinical task with quality improves the overall safety, quality and efficiency of Radiation Therapy. In our department, an internally developed software system that allows quantitative metric and automatic measurement (QMAP) based on data in the clinical Record and Verify (R&V) system has been used to help manage the processes. The purpose of this work is to report our experience applying this system to newly integrated regional radiation oncology systems.

Materials/Methods: Two regional radiation oncology departments were integrated into the enterprise Planning and R&V system in March 2016. As of May 2017, the two departments fully adopted the QMAP system for workflow management. We study two important metrics monitored by QMAP, table position overrides during delivery and late plan completion. The table position override monitoring started in March 2016. The late plan completion and alerting commenced in May 2017. We studied the respective changes of the override rates and late plan completion rates shortly after the adoption of the QMAP system. Table position overrides in the longitudinal, lateral and vertical directions for any external beam treatment after the first fraction were recorded. Patients whose simulation were completed at least 2 business days before the scheduled treatment were included in the study of late plan completion. Plans ready for therapists to check less than four business hours before the scheduled treatment were considered late. Fisher’s exact test was used for statistical analysis.

Results: After the adoption of each QMAP feature by the two departments, root causes for delinquency of each metric were identified and systematic corrective measures were adopted, resulting substantial and sustainable improvement in the respective metrics. From May 2016 to October 2016, 9107 fractions were delivered, with 613 table position overrides. From June 2017 to Nov 2017, 7446 fractions were delivered, with 248 overrides. Override rate was reduced from 6.7% to 3.3% (p<0.01). In the third and fourth quarters of 2017, 97 and 101 plans were completed in the departments, with 27 and 10 plans being late, respectively. The late chart rate was reduced from 27.8% to 9.9% in these two quarters following the integration (p<0.01).

Conclusion: QMAP provides an effective means to identify the bottlenecks in the department workflow. It is effective in reducing override and late plan completion shortly after integration into a regional campus’s workflow, which should help the safety and quality of radiation treatments.

Author Disclosure: N. Yu: None. D. LaHurd: None. J.H. Suh: Consultant; ACMUI. Board member; Korean American Society for Therapeutic Radiation. P. Xia: Employee; Cleveland Clinic. Research Grant; Philips Healthcare.

Send Email for Danielle LaHurd


Assets

TU_26_3064 - Quantitative Metric and Automatic Auditing Program (QMAP) Can be Applied to Regional Sites to Improve Quality and Consistency



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Quantitative Metric and Automatic Auditing Program (QMAP) Can be Applied to Regional Sites to Improve Quality and Consistency