Clinical Outcomes in Adult and Pediatric Ewing Sarcoma: A Single Institution Comparative Study

Abstract

oncology web page to an encrypted database. Forms initially were reviewed at monthly quality assurance meetings. Starting in May 2010, a process improvement team consisting of physician, physicist, dosimetrist, therapist, and nursing group representative met weekly to improve workflow and decrease errors. This group was expanded to non-clinical staff in 2011. Form review priority criteria, solution criteria, and meeting ground rules were set in advance of the first team meeting. Spreadsheets were used to present the forms. Actions, owners, and completion dates were assigned at each meeting. Results: Over 1,182 process improvement reports were recorded. Efforts resulted in many operational changes in the department. In addition to first day therapist chart checklists, physics and dosimetry chart checklists were added and electronically recorded in the every patient’s chart. Table indexing was developed for all patients to minimize potential for wrong site treatment. A Linear Accelerator Field Definition Chart was created to include unique differences in treatment parameters and a Field Definition Chart was created showing screen capture examples of different linear accelerator parameters. Machine parameter spreadsheets were created and are being used by dosimetrists and physicists. Data demonstrated increased adoption by staff over time with increased PIF submission. Forms for incidents reaching the patient decreased, during the same time period that total number of fields treated and complexity of patient set-up increased (Table). Conclusions: The number of errors reaching patients can be positively affected by a continuous improvement program. A continuous quality improvement program can be implemented at a large tertiary teaching institution that can be adapted for smaller radiation oncology departments. Author Disclosure: T. Meier: None. B. Hugebeck: None. T. Kovacs: None. C. Belfi: None. J. Suh: G. Consultant; Abbott Oncology. M. Kolar: None. S. Chao: None.