Patient Safety

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TU_26_3065 - Enhancing Quality Improvement With In Radiation Oncology at a Large Teaching Institution: The Survey Says

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

Enhancing Quality Improvement With In Radiation Oncology at a Large Teaching Institution: The Survey Says
T. Meier1, J. H. Suh2, P. Barrett3, M. Patt2, S. Graham2, and S. T. Chao2; 1Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 2Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, 3Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH

Purpose/Objective(s): To determine the obstacles in growing and maintaining a robust quality improvement (QI) program in radiation oncology. These obstacles include lack of participation and staff’s understanding of the purpose of a QI program. The results of a recent survey to radiation oncology staff were analyzed to identify gaps and areas to address.

Materials/Methods: Despite having a QI program in place for 10 years, it was not until recently our management team fully understood the negativity associated with our QI team. We attempted to also understand why 90% of the forms submitted were by the therapist group, but other groups such as dosimetrists and schedulers rarely submitted forms. Using a simple survey tool, our QI team distributed a survey of 7 questions which identified the user’s work group, asked about their perceptions of quality and the purpose of QI, their knowledge of the QI forms and their usefulness in decreasing error or maximizing efficiency, and how you improve a quality program.

Results: 80 out of 135 department members completed the survey (80/135) (60%). Greatest participation in the survey were from therapists 22/80 (27.5%), followed by staff MD 12/80 (15%), and nurses 11/80 (14%). Lowest participating groups were receptionists 1/80 (1%), dosimetrists 2/80 (2%), and physics residents 2/80 (2%). Of those surveyed 69/70 (99%) agreed that quality has continuously improved. Those surveyed indicated the purpose of the QI team was to report workflow errors 63/79 (80%), track common or frequent errors (69), and improve quality and safety 76/79 (96%). It was revealing to learn “report co-workers who don’t follow standard procedure” 15/79 (19%) was selected as a reason. 21/79 (27%) department members responded they did not know how to access the form. 60/80 (75%) responded they do not regularly submit a QI form. 29/78 (37%) responded the form does not decrease future errors. 36 responded, via verbatim, how to improve our QI program.

Conclusion: Reducing risk to patients, increasing efficiency through improved processes, and reducing costs are critical in healthcare today and are encompassed in QI programs. The QI survey has given our department suggestions for improvement that can be used as a guideline for other departments looking to build QI programs. The results of our survey demonstrate that areas of focus for QI programs include: 1) defining the purpose of the program for all groups, 2) engaging each group on how to be involved in the QI process and the value of the process, and 3) communicating changes derived from the QI process. Together, these findings demonstrate that in order to have a robust program, time and resources must be dedicated, constant assessment and refinement of the QI program including specified communication to low participating groups. Finally, it is important to recognize that almost everyone recognized quality is continuously improving, the key outcome for QI programs.

Author Disclosure: T. Meier: None. J.H. Suh: Consultant; ACMUI. Board member; Korean American Society for Therapeutic Radiation. P. Barrett: None. M. Patt: None. S. Graham: None. S.T. Chao: Honoraria; Varian Medical Systems, Zeiss, Abbvie. Consultant; Abbvie.

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