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PO-1023: Reducing waiting room times - A 5 year review of an in-house KPI tool
S564 ESTRO 36 _______________________________________________________________________________________________
The aim of the study was to evaluate the effectiveness of the new workflow in terms of reducing errors. Material and Methods Since April 2016, a paperless workflow has been introduced for each area of the pathway including; referral, data capture at CT, planning information and treatment information up to the last fraction. A focus group was formed to investigate the options available for recording the required information at all stages. These included using an electronic referral and booking form, dynamic documents for recording treatment setup details, electronic journals for recording actions and histories throughout the treatment and toxicity scoring. All checks required on before, during and after treatments were assigned as tasks or checklists and these were made into a standardised automated protocol.All errors at our centre are recorded electronically on a centralised incidence reporting system. The numbers of error occurrences that happened 3 months before and after the introduction of the process were analysed. Results In total, there were 51 and 49 radiotherapy related incidents recorded before and after the introduction of the paperless workflow respectively. The number of incidents related to transcription errors decreased from 29% (15/51) to 16% (8/49) since the paperless change. It’s noted that there was a small rise in reported incidences in other areas of the pathway due to a change in work procedure. Conclusion It’s suggested the number of transcription errors was minimised through the adoption of the paperless workflow. It’s also proved to be beneficial to have a centralised electronic incident reporting system to monitor and review incidents in a radiotherapy department, in order to streamline and optimise existing patient pathways. PO-1023 Reducing waiting room times - A 5 year review of an in-house KPI tool A. Wallis1, D. Moretti1 1 Liverpool Hospital, Radiation Oncology, Liverpool, Australia Purpose or Objective Patient waiting times has a significant impact in a patient’s overall satisfaction of their healthcare experience (1). The main contributors to patient waiting times are inadequate appointment duration, staff experience level, patient late arrival and machine breakdowns (1). Literature on radiation oncology productivity is dominated by variation and validation of the basic treatment equivalent (BTE) model (2). However, the technological advancements in imaging and treatment modalities such as intensity modulated radiation therapy (IMRT), image guided radiotherapy (IGRT), volumetric RT (VMAT) and Tomotherapy have changed the landscape of RT and its productivity measures (4). In 2011, the management team at Liverpool and Macarthur Cancer Therapy Centres (LMCTC) introduced an in-house key performance indicator (KPI) tool to measure the performance of the treatment machines. The catalyst for the design and implementation of the tool was the introduction of the New South Wales (NSW) Performance Measures report of 2010 (3). The main objective of the tool was to capture each individual patient's appointment time to ensure adequate and individualised patient appointment scheduling. It was hypothesised that the introduction of this tool would reduce the waiting room time for patients. Material and Methods In 2010, Mosaiq 2.0X was installed in LMCTC. This version allowed the extraction of time stamps in a reporting tool (Crystal reports version 11). Standardisation of the treatment processes improved the robustness of patient
data and allowed accurate extraction of time stamps in Mosaiq. This data were then imported into Microsoft Excel on a weekly basis for visual display of the KPIs. The tool was launched in October of 2010 for a trial period of two months and has been in use in the department since its introduction. Results During the period of October to December 2010, the department recorded that 56% of patients were treated on time. Since the tool was introduced and actioned in 2011, the department has recorded an average of 71.2% (range 69-76%) of patients treated on time. These results are encouraging considering the number of attendances to the department has increased over the 5 year period (Fig 1). The percentage of patients arriving late to their appointment is 8% (range 7.0-9.1) (Table 1). The average waiting room time for a patient is 3.5 minutes (range 2.3 – 4.5 minutes).
Conclusion The development of an in-house KPI tool has reduced waiting time for patients at LMCTC. Since the introduction of the tool we have increased the number of patients treated on time from 56% to 71.2% over the past 5 years. This is despite the increasing patient attendances and changes in technology and complexity. Interestingly, despite improvements from hospital management to improve parking and access to the departments, 8% of patients do not arrive on time for their appointment. PO-1024 Effectiveness of couch coordinate constraints to reduce error rates in radiation therapy delivery O. Nairz1, N. Breitkreutz1 1 MVZ InnMed, Strahlentherapie, Oberaudorf, Germany Purpose or Objective “Movement from reference marks” is one of the most error-prone steps in the radiation therapy process. The use of indexed immobilization devices and constrained absolute, patient specific couch coordinates is generally considered to be an efficient tool to reduce the risk of radiation therapy errors (RTE) during treatment delivery. In the light of implementing a quantitative risk assessment we analyzed table coordinates of patients treated in our department. We investigated the effectiveness of tolerance values to lower the incidence of both wrong movements from reference marks and irradiation of the wrong patient or isocenter. Material and Methods Actual table values of patients in treatment position during a period of 18 months were extracted from the records of the verification system. Patient setups were
The aim of the study was to evaluate the effectiveness of the new workflow in terms of reducing errors. Material and Methods Since April 2016, a paperless workflow has been introduced for each area of the pathway including; referral, data capture at CT, planning information and treatment information up to the last fraction. A focus group was formed to investigate the options available for recording the required information at all stages. These included using an electronic referral and booking form, dynamic documents for recording treatment setup details, electronic journals for recording actions and histories throughout the treatment and toxicity scoring. All checks required on before, during and after treatments were assigned as tasks or checklists and these were made into a standardised automated protocol.All errors at our centre are recorded electronically on a centralised incidence reporting system. The numbers of error occurrences that happened 3 months before and after the introduction of the process were analysed. Results In total, there were 51 and 49 radiotherapy related incidents recorded before and after the introduction of the paperless workflow respectively. The number of incidents related to transcription errors decreased from 29% (15/51) to 16% (8/49) since the paperless change. It’s noted that there was a small rise in reported incidences in other areas of the pathway due to a change in work procedure. Conclusion It’s suggested the number of transcription errors was minimised through the adoption of the paperless workflow. It’s also proved to be beneficial to have a centralised electronic incident reporting system to monitor and review incidents in a radiotherapy department, in order to streamline and optimise existing patient pathways. PO-1023 Reducing waiting room times - A 5 year review of an in-house KPI tool A. Wallis1, D. Moretti1 1 Liverpool Hospital, Radiation Oncology, Liverpool, Australia Purpose or Objective Patient waiting times has a significant impact in a patient’s overall satisfaction of their healthcare experience (1). The main contributors to patient waiting times are inadequate appointment duration, staff experience level, patient late arrival and machine breakdowns (1). Literature on radiation oncology productivity is dominated by variation and validation of the basic treatment equivalent (BTE) model (2). However, the technological advancements in imaging and treatment modalities such as intensity modulated radiation therapy (IMRT), image guided radiotherapy (IGRT), volumetric RT (VMAT) and Tomotherapy have changed the landscape of RT and its productivity measures (4). In 2011, the management team at Liverpool and Macarthur Cancer Therapy Centres (LMCTC) introduced an in-house key performance indicator (KPI) tool to measure the performance of the treatment machines. The catalyst for the design and implementation of the tool was the introduction of the New South Wales (NSW) Performance Measures report of 2010 (3). The main objective of the tool was to capture each individual patient's appointment time to ensure adequate and individualised patient appointment scheduling. It was hypothesised that the introduction of this tool would reduce the waiting room time for patients. Material and Methods In 2010, Mosaiq 2.0X was installed in LMCTC. This version allowed the extraction of time stamps in a reporting tool (Crystal reports version 11). Standardisation of the treatment processes improved the robustness of patient
data and allowed accurate extraction of time stamps in Mosaiq. This data were then imported into Microsoft Excel on a weekly basis for visual display of the KPIs. The tool was launched in October of 2010 for a trial period of two months and has been in use in the department since its introduction. Results During the period of October to December 2010, the department recorded that 56% of patients were treated on time. Since the tool was introduced and actioned in 2011, the department has recorded an average of 71.2% (range 69-76%) of patients treated on time. These results are encouraging considering the number of attendances to the department has increased over the 5 year period (Fig 1). The percentage of patients arriving late to their appointment is 8% (range 7.0-9.1) (Table 1). The average waiting room time for a patient is 3.5 minutes (range 2.3 – 4.5 minutes).
Conclusion The development of an in-house KPI tool has reduced waiting time for patients at LMCTC. Since the introduction of the tool we have increased the number of patients treated on time from 56% to 71.2% over the past 5 years. This is despite the increasing patient attendances and changes in technology and complexity. Interestingly, despite improvements from hospital management to improve parking and access to the departments, 8% of patients do not arrive on time for their appointment. PO-1024 Effectiveness of couch coordinate constraints to reduce error rates in radiation therapy delivery O. Nairz1, N. Breitkreutz1 1 MVZ InnMed, Strahlentherapie, Oberaudorf, Germany Purpose or Objective “Movement from reference marks” is one of the most error-prone steps in the radiation therapy process. The use of indexed immobilization devices and constrained absolute, patient specific couch coordinates is generally considered to be an efficient tool to reduce the risk of radiation therapy errors (RTE) during treatment delivery. In the light of implementing a quantitative risk assessment we analyzed table coordinates of patients treated in our department. We investigated the effectiveness of tolerance values to lower the incidence of both wrong movements from reference marks and irradiation of the wrong patient or isocenter. Material and Methods Actual table values of patients in treatment position during a period of 18 months were extracted from the records of the verification system. Patient setups were