ESTRO 2020 Abstract Book

S1081 ESTRO 2020

Cancer Centre, Clinical Oncology, Edinburgh, United Kingdom

standards that uses only electronic procedures for managing the patient’s workflow. Material and Methods The tasks and activities related to patient flow management have been identified and created digitally in the ARIA computer system (Varian Medical System) according to the workflow carried out based on the JCI standards. Each element of the workflow corresponds to an activity or a task associated with a staff group (Administrative, Medical, Physical, Nurses and Technicians). The time that elapses between one activity and the next has been defined based on the timing found in the department + to carry out the activities themselves, the number of personnel involved and the standards regarding the waiting time of the center. Since the closure of the activities is recorded automatically by the IT system, it was possible to use reports generated by ARIA to calculate the quality indicators. The analysis was based on data regarding the period from January 2019 to August 2019. The quality indicators selected were: Personnel compliance in the use of automated activities; Percentages of completion of the automatic care pathway activities; Waiting times between the different activities of the treatment paths, from the first radiotherapy consultation to the treatment. Results The quality indicators taken into consideration are suitable for the activities of the center, managing to highlight the most critical areas and therefore sensitive to improvements. Staff compliance in the use of automated activities was on average higher (91%) in the first four months compared to the second (80%) with a clear decline in July. The indicator relating to the percentages of completion of the activities shows the adherence already acquired to the closure of some tasks such as the Time Out of radiotherapy treatments with average completion of 92% and the critical issues related to other activities, for example the closure of the folder has an average completion of about 43%. The waiting times of the activities are on average always higher than our reference standard, but there is an improvement trend in all the activities analyzed. Conclusion The EMR system allows you to accurately analyze the performance delivered in radiotherapy departments, creating versatile quality indicators, which can be customized through the creation of adhoc care pathways, make it possible to achieve high quality levels in the accreditation phase by international commissions and guarantee the monitoring of areas that need improvement. PO-1944 FMECA analysis of VMAT prostate treatment A. Lastrucci 1 , M. Betti 1 , L. Marciello 1 , E. Serventi 1 , Y. Wandael 2 , L. Ferreri 1 , S. Segnini 1 , M.A. Spediacci 1 , L. Fedeli 1 , F. Meucci 1 , S. Marzano 1 , R. Ricci 1 1 USL Toscana Centro, Radiotherapy, Prato, Italy ; 2 A.O.U. Careggi, Radiotherapy, Florence, Italy Purpose or Objective FMECA (Failure Modes, Effects and Criticality Analysis) is a prevention tool with a proactive approach that allows for the identification and subsequent prevention of diverse process risk phases. This study reports the results obtained from FMECA analysis applied to VMAT (Volumetric Modulated Arc Therapy) of patients undergoing radiotherapy treatments at Santo Stefano Hospital in Prato, Italy. Material and Methods A multidisciplinary team was composed of 8 health care professionals; the team leader was the Department Manager. VMAT prostate treatments was divided into 7 steps: Step 1: Admission and medical examination, Step 2: Programming, Step 3: Simulation CT scan, Step 4: RT

Purpose or Objective In August 2017 the Royal College of Radiologists (RCR) published guidance on radical radiotherapy planning and peer reviews[1]. The guidance highlighted the importance of clinician to clinician peer review to maintain consistent, high quality target definition when contouring radical treatment volumes. No such guidance exists for palliative radiotherapy, although publications have highlighted the importance and benefit of undertaking such a task as a method of quality control and to reduce errors[2]. The following describes how one radiotherapy department has recently implemented a regular audit of palliative radiotherapy planning with results from the most recent audit presented. [1] The Royal College of Radiologists. Radiotherapy Target Volume Definition and Peer Review. 2017 [1] Thompson D, Cox K, Loudon J, Yeung I, Wells W. Outcomes of peer review for radiotherapy treatment plans with palliative intent. Journal of Oncology Practice 2018 14:12, e 794- e800 Material and Methods The audit team comprises of 3 clinical oncologists and 3 RTTs. All palliative patients planned over the course of 1 week, chosen at random, are examined. Patient notes are gathered prior to the audit. An audit form has been created to highlight the areas to be examined and reported on. Results A total of 24 palliative radiotherapy treatment plans were audited. 8 of the 24 cases were found not have any case notes available at time of planning, however electronic notes could be accessed. 12 of the 24 patients did not have documentation noting dose, fractionation or a reason for delivering radiotherapy. A number of further issues were raised concerning consistency between tumour sites and legibility of documents. Soft tissue and lymph node planned treatment volumes caused the biggest discussion between the group. Conclusion Results have been presented to all staff groups. Feedback is actively encouraged and disseminated throughout all disciplines in the department by regular meetings. As a result of the audit a number of changes have so far been implemented. A ‘planning pause’ document has been created to address departmental protocols, clinical areas have been clearly defined in the CT scanners with only those involved directly in the procedure to be present and prescribing protocols have been updated to improve consistency between prescribers. The palliative audit is to be repeated every six months. To eliminate bias in reported outcomes staff will rotate throughout the group. PO-1943 Analysis of RT performance using quality indicators derived from automated treatment pathways L. Capone 1 , D. Di Minico 2 , B. Nardiello 1 , F. Lusini 1 , F. Cavallo 2 , B. Tolu 1 1 UPMC San Pietro FBF, Radiotherapy, Rome, Italy ; 2 UPMC Hillman Cancer Center Villa Maria, Radiotherapy, Mirabella Eclano, Italy Purpose or Objective Quality indicators are standardized and evidence-based measures of health care that can be used with administrative data to track performance and clinical outcomes. This study analyzes the quality indicators needed in a cancer center accredited by international JCI Poster: RTT track: Risk management/quality management