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the planning and adjustment of the project. In this way
the RTTs felt an ownership of the project while the new
tasks
were
considered
meaningful
too.
Future areas for improvement involve the patients’
perspectives of the consultations and the need assessment
preparation
tool.
EP-1859 RTTs challenge’s in re-plan decision
D. Radola
1
1
Greater Poland Cancer Centre, Radiotherapy
Department II, Poznan, Poland
Purpose or Objective
Important role of imaging, and verification on medical
accelerator depend on RTT team. From the past three
years, our Oncology Center develop advance scope of
practice dedicated to RTT depend on the level of the
education, allowed to managed and build strong team.
The priority is quality of the treatment. The main aim of
this work is to present changes in responsibility in daily
practice of the RTT allowed to improve the quality of
treatment, by fast detection of possible residual errors in
radiotherapy.
Material and Methods
Radiation Technology’ tasks included: patient positioning,
portal verification, irradiation delivery. The scope of
licentiates’ responsibilities (equivalent of bachelor’s
degree –) was extended to include QA dosimetric
procedures and the preparation of accelerators. The
existing duties of RTT with magister’s degree (equivalent
of master’s degree) were extended and supplemented
with new competences. These included the supervision of
the work on the accelerator, decisions on replanning,
assistance to the radiation therapist in preparing patients
for treatment, (immobilisation, iCT, organ at risk
contouring, verification of ready treatment plans on the
simulator).
Results
In 2011/12 number of re-plan was (481) and (523) which
correspond with 10% of all treating patient in our Center.
In 2013 we start developing idea of advance scope of
practice of our RTT. Next two years of experience in
Immobilization, treatment preparation, and contouring
indicate increasing number of quality control. Number of
re-plan in 2014/ 2015 was (581) (566) which corresponding
with 11.5% and it was higher by 1,5% according to first two
years. Time of patient preparation for treatment
(Immobilization, Ct-scan, Contouring, QA) decrease from
5 (days) to 4 (days).
Conclusion
Advance role of the RTT significant increasing their
academic competency, affect on the quality control in the
process of radiotherapy. New role of RTT, allow to
increase patient safety, higher standards of the treatment
and advance decisions making based on the image
registration corresponding with number of re-plan.
Further developing of the role should open more advance
scope of practice of modern RTT.
Electronic Poster: RTT track: Risk management/quality
management
EP-1860 A process and human factors engineering
paradigm for radiation oncology
K.C. Chan
1
, W.Y. Lee
1
1
Hong Kong Sanatorium & Hospital, Department of
Radiotherapy, Hong Kong, Hong Kong SAR China
Purpose or Objective
The ever-advancing Radiation Oncology has become a
technologically based speciality. The automation-based
advances in radiotherapy bring new challenges to patients
and the department in terms of safety and quality. The
knowledge of process and human factors
engineering was
incorporated in the implementation of Radiation Oncology
Information System (ROIS) and its integration with the
Hospital Information System (HIS) at the department. It
aimed to enhance radiotherapy planning and treatment
efficiency, quality and safety. Since HIS is the central
patient data source of the department, this project also
aimed at integrating the two systems to maintain patient
record integrity.
Material and Methods
Before clinical implementation, a project team was
formed in preparation for the implementation of ROIS and
its integration with HIS. The end-to-end radiotherapy
process was reviewed. A dedicated testing database
environment was built to assess usability requirements.
Main requirements, risk areas and contingency measures
were identified. Application training was given to all
stakeholders in the department so as to cultivate
understanding of MOSAIQ and ensure familiarity with the
use. Integration of ROIS with HIS required analysis of
computer information flow. The method of
communication and the type of data sent between each
component were examined (Figure 1).
Figure 1. Diagram of information flow between different
components within the department.
Results
Machine interfacing was completed in August 2014. Since
then, our department started treating patients with
MOSAIQ as the ROIS. The implementation incorporated key
concepts of process engineering. Efficiency, quality and
safety could be improved by streamlining processes,
removing ambiguity, improving communication and
standardizing workflow. The knowledge of human factors
engineering, namely automation, forced function,
simplification and standardization, was applied to design
the new working procedures for safe and effective human
use. The implementation of MOSAIQ made process
improvement possible by setting code capture mandatory
at certain stages within the radiotherapy process. The
codes captured set the foundation for clinical data
acquisition and statistics purpose. The ROIS was
successfully integrated with HIS, which automated patient
registration (Figure 2) and charging process.
Figure 2. Flowchart showing how auto-registration is done
via HL7.
Conclusion
To conclude, the enhanced efficiency and quality after
implementation of ROIS showed the potential to reduce
errors and improve safety. The integration with HIS