Increasing on-treatment visit compliance for radiation therapy cancer patients.

Abstract

175 Background: Weekly on-treatment-visits (OTVs) represent standard care in radiation oncology and have significant impact on the quality of patient care. Ensuring that OTVs are completed might decrease the severity of acute treatment-related side effects by facilitating timely treatment of symptoms. This study evaluates factors contributing to missed OTVs and formulates a plan to mitigate this problem. Methods: A multidisciplinary team of radiation oncology staff members reviewed clinical work flow data to determine the number of patients missing their weekly OTVs. These numbers generated benchmarks for the QIP. The team used 30 patient questionnaires and 291 electronic medical records to identify the causative factors for missing the OTVs. After analyzing these results the team generated an action plan for multiple interventions and future audit protocols. Results: On average, 5% of patients miss their weekly OTVs during radiotherapy course. The identified reasons which affected patient compliance with OTVs include: patient inconvenience waiting for the MD, parking concerns, difficulty navigating the clinic to find the exam room, failure of therapist to send the patient for OTVs, changes in MD’s schedule, lack of patient awareness about expected treatment related side effects and importance of immediate treatment of their symptoms. We developed a multidisciplinary plan to minimize patients missing OTVs which includes electronic medical record alerts, communication cues, physical triggers and improved patient education. Additionally, electronic data collection has been implemented for OTV performance metrics and auditing. Conclusions: Patients missing their weekly OTVs during radiotherapy course might be at risk for more severe treatment-related side effects. The details of this multidisciplinary QIP implementation and its impact on quality of care will be presented at the meeting.