Improving Radiation Oncology (RO) Quality and Workflow by Implementation of a Standardized Daily Huddle

Abstract

Given complex operations across 10 clinical sites, our department developed a standardized daily huddle to streamline treatment (tx) workflow, proactively identify patient (pt) safety issues, disseminate important messaging, and ensure effective communication across the care team.An SQL script was iteratively developed with user input to query data from 3 platforms (RO pt data platform, medical record, institutional data warehouse) to extract data on scheduling, physician (MD) tasks (documentation, plan/imaging review, billing approval, due dates), and pt specifics. The abstracted data was then adapted to a visual interface.Complex nightly queries interrogate multiple data sources, resulting in 10 data fields relevant to daily departmental workflow (see Table 1).Our standardized huddle has been instituted at all clinical sites and is coordinating care for 400+ pts daily. A model to incorporate feedback for updates allows continuous improvement. Initial responses suggest it is an effective tool for interdisciplinary communication in a time efficient manner, quality data tracking and real-time adjustment as issues arise. In comparison to commercial products, this platform allows more customization for department-specific workflows at the cost of increased development effort. Collected data has permitted generation of an automated daily "MD work summary" email that is automatically sent to all network MDs and highlights specific tasks needing completion for planning, setup, and tx. It has supplanted numerous other emails that were previously needed to coordinate these time-sensitive tasks. Over the comings weeks/months we plan to study adherence to planning timelines, time to IGRT approval, time to treatment, missed OTVs, and falls as important quality outcomes following implementation of this system. While reproducibility depends on practice-specific needs and available data, this proof-of-concept demonstrates development of a tool to guide and support high-level departmental initiatives. The ideal design process is guided by a small team with a focus on user interface design to inform desired queries.