Co-ordinating Care for Prostate Brachytherapy Patients: Piloting a New Role for the Brachytherapy Clinical Specialist Radiation Therapist (CSRT)

Abstract

Care coordination is defined as efficient and effective use of healthcare resources to improve the quality of care delivered to patients and their outcomes (1, 2). Given the complex nature of preparing for brachytherapy treatments for prostate cancer patients, a coordinator role was piloted to understand the potential impact the role could have for the patient and the system. Between November 2016 and November 2017, a role was piloted to aid in coordinating the prostate cancer patients’ movement through the system, be a primary contact for patient at first referral, provide a robust connection point throughout the patient journey with brachytherapy, and ensure the patient is clear about expectations, requirements and scheduling. Target patient population were those seen at a peripheral clinic or who received a virtual consultation via Ontario Telemedicine Network (OTN) with one Radiation Oncologist (RO). The Brachytherapy CSRT ensured proper work up for the patient, coordinated appointments, made appropriate referrals when necessary, provided patient education regarding upcoming brachytherapy appointment. This pre-op work was coordinated virtually. Workload was captured for each patient via MOSAIQ. Initial impact was assessed through a documentation audit. Frequency of patient preparedness, completion of anaesthesia questionnaire, and completion of pre-op bloodwork and ecg are reported for all prostate patients treated during the time period. A total of 32 patients were treated with brachytherapy of which 24 patients were coordinated by the CSRT and 7 patients were not. For patients not coordinated by the CSRT, two patients expressed not being prepared for the procedure and required further information, 1 patient did not have the anaesthetic questionnaire completed, 8 patients did not have pre-op bloodwork and ecg completed. For patients coordinated by the CSRT, 1 patient required further clarification about preparation for brachytherapy treatment; for all other work up was complete. The Brachytherapy CSRT coordinator role appears to move the patient through the system more seamlessly. Further investigation is required to understand the full impact this role could have on the patient and the system.