Improving patient safety and workflow efficiency with standardized pre-treatment radiation therapist chart reviews

Publication date: Available online 2 February 2017
Source:Practical Radiation Oncology
Author(s): Kelly Cooper Younge, Katherine Woch Naheedy, Joel Wilkinson, Joumana Dekmak, Elizabeth Covington, Bonnie Durbin, Eric Nelson, Stephanie Filpansick, Jean M Moran
PurposeTherapists play a critical role in ensuring patient safety, however, they are sometimes given insufficient time to perform quality assurance of a patient's treatment chart and documentation prior to the start of treatment. In this work, we show the benefits of introducing a formal therapist pre-start QA checklist, completed in a quiet space well in advance of treatment, into our workflow.Materials and MethodsA therapist pre-start QA checklist was created by analyzing in-house variance reports and treatment unit delays over a period of six months. Therapists were then given dedicated time and a workspace to perform their checks within the dosimetry office of our department. The effectiveness of the checklist was quantified by recording the percentage of charts QA'ed prior to treatment, the percentage of charts with errors needing intervention, and treatment unit delays over a nearly two year time period. The frequency and types of errors found by the pre-start QA were also recorded.ResultsThrough the use of therapist pre-start QA, instances of treatment unit delays were reduced by up to a factor of nine over the first year of the program. At the outset of this new initiative, nearly 40% of charts had errors requiring intervention, with the majority being scheduling-related. With upstream workflow changes and automation, this was reduced over the period of a year to about 10%.ConclusionThe number of treatment unit delays was dramatically reduced through the use of a formal therapist pre-start QA checklist completed well in advance of treatment. The data collected via the checklist continues to be used for further quality improvement efforts.



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