Impact of a Patient Tracking Dashboard on the Timeliness for Chart Check in a Community-Based Radiation Oncology Department

Abstract

<h3>Purpose/Objective(s)</h3> One of the cornerstones for the safe delivery of radiation treatment is the chart check completed by the radiation therapist. It is recommended that the therapists have adequate time to complete this check. We set an institutional quality improvement goal for non-urgent cases to be ready for chart check at least one day prior to the verification day/first fraction. We report the impact of a patient-tracking dashboard to improve this quality metric at our community-based radiation oncology department. <h3>Materials/Methods</h3> We constructed a custom patient tracking dashboard within Microsoft Teams. Patients were added to the dashboard during CT simulation along with other information including physician, radiation technique, planned start date, and step in the planning process. Dashboard was available to all members of the department, updated daily and reviewed during morning huddle. The dashboard was then piloted at one of four departments in the health system starting in January 2021. Charts that were completed and ready for review at least 1 day prior to the start date were considered "on-time". Those that were deemed "urgent" were excluded from this quality metric. All other charts, which were ready for final check on the same day of treatment, were considered "late". We evaluated the impact of the dashboard pilot on on-time percentage. All comparisons are made using chi square analysis. <h3>Results</h3> The study period covered 16 months and 398 patients, including 4 months prior to the dashboard pilot (n=84, 09/2020–12/2020) and 12 months following (n=314, 01/2021–12/2021). As expected, there was no difference in the percent of patients considered urgent before and following the pilot (22.6% vs. 17.5%, <i>p</i>=NS). There was a significant improvement in the on-time percentage following the dashboard pilot (60.0% vs. 94.9%, <i>p</i><0.0001). On-time performance was also analyzed at the other radiation oncology departments in the health system, which were subject to the same quality improvement goals but were not part of the pilot (n=1,217). No difference was found in the on-time percentage over the same study period (84.9% vs. 84.2%, p=NS). On-time percentage was significantly higher with the pilot than in the departments which had not yet implemented (94.9% vs. 84.2%, <i>p</i><0.0001). <h3>Conclusion</h3> We found that the pilot implementation of a patient tracking dashboard significantly increased the percentage of patients meeting our quality goal of having charts available for check at least one day prior to start of treatment from 60.0% to 94.9%. The dashboard was easily built internally and implemented without any additional investment. We found that this approach was well received and helped promote safety and efficiency, especially during the pandemic when the department experienced staffing shortages and cross-coverage. We hope to expand use of the dashboard across the system and potentially to other aspects of the care continuum for cancer patients.