Implementing Technology to Drive Improvements within a High Volume Brachytherapy Program

Abstract

The introduction of new techniques and technologies in radiation therapy has the potential to improve outcomes; however, initial implementation is often associated with a steep learning curve and decreased efficiencies. We describe the development, implementation and evaluation of implementing an operating room scheduling system, electronic documentation software and a patient tracking system within a high throughput, high volume brachytherapy program. In 2017, a small interprofessional team came together to introduce two key technologies into the brachytherapy program; 1) TrackOR to improve patient flow through the unit and 2) PICIS OR Manager to centralize scheduling to provide targeted access to the unit and collect specialized data elements related to the program and provincial initiatives. In addition, the program shifted all documentation to an electronic platform to align documentation practice with the rest of the Radiation Treatment Program and provide access of care notes to healthcare teams across the organization. To promote adoption into clinical practice, a multistep approach was used. Current state workflow maps were created with feedback from all key stakeholders. Future state workflows were created layering the new technologies and process at the key points within the pathway. Training and education was completed with all end users and dry runs of the future state workflow was completed prior to implementation. To ensure success, intensive support was provided during the first two weeks of implementation with debriefs occurring near the end of each clinical day with the interprofessional team to address issues and concerns. The implementation of the scheduling and patient tracking software provides the ability to maximize OR utilization through the assignment of procedures in a systematic way. In addition, the program monitors the timing of procedures by physician which allows for optimized daily scheduling. In addition, the system tracks start and stop times to improve throughput and minimizes staff overtime. Challenges were seen in moving documentation practice to an electronic platform as there was a learning curve to using the software in real time. Integration of this software has allowed for the optimization of brachytherapy OR utilization to nearly 100% month over month and has allowed for provincial access to brachytherapy treatment targets to be reached and maintained.