Improving Patient Compliance for Gynecological Brachytherapy Procedures at a High-Volume Center

Abstract

PurposeThe Radiation Oncology Department at Magee-Women’s Hospital of UPCI provides gynecological brachytherapy services for a large number of patients in Western Pennsylvania and surrounding areas (about 1000 fractions per year). These procedures are complex and require preparation and coordination between a number of departments including ultrasound, anesthesia, and radiation oncology. Historically, the patient compliance rate for these procedures was 90%. Patient noncompliance resulted in lengthening of overall treatment time and scheduling difficulties. The most common reasons for noncompliance were lack of transportation and poor compliance with pre-procedure instructions. We therefore implemented several measures with the goal of improving the compliance rate above 95%.Materials and MethodsA daily schedule was provided to the anesthesia and ultrasound departments to coordinate and ensure procedures started on time. Each patient met with the social worker to address any potential transportation barriers. Patients watched an educational video explaining the brachytherapy procedure. The brachytherapy coordinator and nurse spoke to each patient and completed a checklist which reviewed dates and times of the procedures, reviewed pre-anesthesia instructions, and confirmed transportation. Compliance was periodically reviewed at staff meetings.ResultsThe above measures were implemented between April 1st, 2015, and December 31st, 2015. 179 patients were treated with 668 fractions. 8 patients were noncompliant for 13 fractions. Overall compliance rate was 98%. The most common reasons for noncompliance were illness and no show.ConclusionsIn a high-volume cancer center, implementing social work support, educational videos, and a checklist resulted in improved compliance for patients undergoing gynecological brachytherapy procedures. PurposeThe Radiation Oncology Department at Magee-Women’s Hospital of UPCI provides gynecological brachytherapy services for a large number of patients in Western Pennsylvania and surrounding areas (about 1000 fractions per year). These procedures are complex and require preparation and coordination between a number of departments including ultrasound, anesthesia, and radiation oncology. Historically, the patient compliance rate for these procedures was 90%. Patient noncompliance resulted in lengthening of overall treatment time and scheduling difficulties. The most common reasons for noncompliance were lack of transportation and poor compliance with pre-procedure instructions. We therefore implemented several measures with the goal of improving the compliance rate above 95%. The Radiation Oncology Department at Magee-Women’s Hospital of UPCI provides gynecological brachytherapy services for a large number of patients in Western Pennsylvania and surrounding areas (about 1000 fractions per year). These procedures are complex and require preparation and coordination between a number of departments including ultrasound, anesthesia, and radiation oncology. Historically, the patient compliance rate for these procedures was 90%. Patient noncompliance resulted in lengthening of overall treatment time and scheduling difficulties. The most common reasons for noncompliance were lack of transportation and poor compliance with pre-procedure instructions. We therefore implemented several measures with the goal of improving the compliance rate above 95%. Materials and MethodsA daily schedule was provided to the anesthesia and ultrasound departments to coordinate and ensure procedures started on time. Each patient met with the social worker to address any potential transportation barriers. Patients watched an educational video explaining the brachytherapy procedure. The brachytherapy coordinator and nurse spoke to each patient and completed a checklist which reviewed dates and times of the procedures, reviewed pre-anesthesia instructions, and confirmed transportation. Compliance was periodically reviewed at staff meetings. A daily schedule was provided to the anesthesia and ultrasound departments to coordinate and ensure procedures started on time. Each patient met with the social worker to address any potential transportation barriers. Patients watched an educational video explaining the brachytherapy procedure. The brachytherapy coordinator and nurse spoke to each patient and completed a checklist which reviewed dates and times of the procedures, reviewed pre-anesthesia instructions, and confirmed transportation. Compliance was periodically reviewed at staff meetings. ResultsThe above measures were implemented between April 1st, 2015, and December 31st, 2015. 179 patients were treated with 668 fractions. 8 patients were noncompliant for 13 fractions. Overall compliance rate was 98%. The most common reasons for noncompliance were illness and no show. The above measures were implemented between April 1st, 2015, and December 31st, 2015. 179 patients were treated with 668 fractions. 8 patients were noncompliant for 13 fractions. Overall compliance rate was 98%. The most common reasons for noncompliance were illness and no show. ConclusionsIn a high-volume cancer center, implementing social work support, educational videos, and a checklist resulted in improved compliance for patients undergoing gynecological brachytherapy procedures. In a high-volume cancer center, implementing social work support, educational videos, and a checklist resulted in improved compliance for patients undergoing gynecological brachytherapy procedures.