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The Canadian Partnership for Quality Radiotherapy: Why us? Why now? And What About You?
two years at Carlo Fidani and has been highly successful, allowing us flexibility for movement of staff into planning to cover vacation and increased workload. The staff participating remains highly skilled as floats, and all have continued to increase their skills, training for IMRT and VMAT planning. Due to the success of the model we are currently adapting it for the Brachytherapy program. Recommendations: This poster will detail our 10-hour model, and describe how we adapted the schedule to accommodate the staff interest. We will also discuss the future plans for increasing the skill set of staff with the Brachytherapy implementation.
WORKSHOPS
The Canadian Partnership for Quality Radiotherapy: Why us? Why now? And What About You? Brian Liszewski, MRT(T), BSca, Caitlin Gillan, MRT(T), BSc, MEdb, Gunita Mitera, BSc, MRT(T), MBA, PhD(c)c, John French, DCR(T) MSc, FCAMRT, CHEd, Suzanne Drodgee, Eve-Lyne Marchand, BSc, MD, PhD, FRCPCf, Jean-Pierre Bissonnette, PhD, MCCPM, FCOMPb, Erika Browng, Michael Brundage, MDh and Peter Dunscombe, BSc, PhDi a Odette Cancer Centre, Sunnybrook Health Sciences Centre b Department Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre c Canadian Partnership Against Cancer d British Columbia Cancer Agency e Cross Cancer Institute f Hopital Maisonneuve Rosemont g Canadian Partnership for Quality Radiotherapy h Department of Oncology, Queen’s University Queen’s Cancer Research Institute Kingston Regional Cancer Centre i Department of Oncology, University of Calgary Tom Baker Cancer Centre Background: The Canadian Association of Medical Radiation Technologists’ (CAMRT) Standards of Practice provide direction to achieve and maintain the technologist’s contribution to the health care system. In the practice of radiation medicine these Standards provide radiation therapists (RTT) with expectations of performance for practice. One such expectation is that the RTT ‘‘have a quality management responsibility in the application of continuous quality improvement (CQI) principles in all aspects of the profession’’. This can apply at the clinical front lines, at the institutional level, or within the broader Canadian healthcare system. The Canadian Partnership for Quality Radiotherapy (CPQR) was founded in 2010 as an alliance among the national professional organizations involved in the delivery of radiation treatment in Canada: the CAMRT, the Canadian Association of Radiation Oncology (CARO), and the Canadian Organization of Medical Physicists (COMP) together with strategic and financial support from Canadian Partnership Against Cancer (CPAC). The vision and mandate of the CPQR is to support and promote the universal availability of high quality and safe radiotherapy for all Canadians through system performance initiatives aimed at improving quality and mitigating risk. CPQR activities centre on quality improvement, systems performance and knowledge management. The priority areas determined by the CPQR Steering Committee in consultation with clinical practitioners, cancer program leadership, provincial cancer agencies and international collaborators include; Quality assurance guidance and indicators for radiation treatment programs Technical quality control guidance and indicators for radiation treatment equipment A national reporting system for radiation treatment incidents Ensuring that patients are satisfied with the quality and safety of their treatment These program areas were identified as offering the greatest potential to improve quality and safety and mitigate risk. Engaging interprofessional
efforts in these key aspects of cancer care will help improve the quality and safety of radiation treatment in Canada and will reduce the burden of cancer in Canada long-term. Intended Outcomes: 1. Highlight priorities for national quality initiatives over the next 2-5 years, from the perspectives of each of the professional disciplines involved in radiation treatment delivery 2. Provide Radiation Therapists with strategies for interprofessional collaboration in quality assurance. 3. Continue a dialogue within the Canadian Radiation Therapy community regarding quality issues and improvement Structure: Theory (20min); Practical (30min); Review (10min). The format of the theory portion of workshop will specifically highlight opportunities for radiation therapy engagement within the four quality initiative areas of the CPQR. The interprofessional theory discussion will emphasize the collaborative approach the CPQR utilizes to improve the quality and safety of radiation treatment in Canada. The practical portion of workshop will offer Radiation Therapy delegates with the interactive opportunity to; provide feedback on the CPQR quality initiatives and quality concerns (through the use of the audience response system); formulate approaches for further quality improvements and engagement. An Interactive Discussion on the Role of Knowledge Based Planning in the Canadian Radiation Therapy Department Keith Sutherland, RTT, CMD, ACT, CTIC Cancer Care Manitoba Knowledge Based Planning (KBP) is a software tool capable of predicting the dose volume histogram (DVH) of different structures based on their geometric relationship to the target. This previously unavailable information offers an attractive set of possibilities for the Medical Dosimetrist that could improve the planning process. This presentation will discuss KBP and its potential role in the planning process of radiation therapy (RT), and facilitate discussion on the possible uses of this in a Canadian oncology center. RT planning has rapidly evolved in the past 15 years, moving from 2D planning to computer tomography based 3D planning as well as introducing inverse planning. These techniques have improved our ability to deliver conformal dose distributions to the target while sparing the dose to surrounding normal tissues. The quality of the final plan, however, greatly depends on the planning objectives that the software is given, which is in turn dependent on the users experience with the software and treatment site. KBP aims to reduce the effect that user variability has on final plan quality. This is done by using a ‘‘model’’ built with optimal treatment plans as a reference. KBP identifies the relationship between the dose to organs at risk and treatment targets given the relative geometry and departmental planning technique. This information is used to estimate the DVH for each new patient based on past plans with similar characteristics. Furthermore, these estimates can be used to create optimization objectives that will guide the inverse planning process. The use of KBP could benefit staff less experienced with inverse planning, allowing them to achieve plans comparable in quality to those of experienced planners. Experienced planners may also benefit from an initial set of objectives that will yield a plan of high quality, reducing the time and effort required for plan optimization. Additionally, KBP could be used as a tool to quantitatively verify the quality of an RT plan, and as a training tool for new planners. This could translate into improvements in average plan quality, reduction in inter-patient plan variability, improvement in patient throughput, and potentially patient outcomes. Sexual Health Issues in Gynecological Cancer Patients Receiving Radiotherapy: Radiation Therapists’ Role in Technical and Supportive Care Angela S. Turner, MRT(T), MHSca and Kitty Chan, Hon BSc, MHSc, MRT(T)b a Odette Cancer Centre b Princess Margaret Cancer Centre
Conference Proceedings from RTi3 2014/Journal of Medical Imaging and Radiation Sciences 45 (2014) 162-188
187
WORKSHOPS
The Canadian Partnership for Quality Radiotherapy: Why us? Why now? And What About You? Brian Liszewski, MRT(T), BSca, Caitlin Gillan, MRT(T), BSc, MEdb, Gunita Mitera, BSc, MRT(T), MBA, PhD(c)c, John French, DCR(T) MSc, FCAMRT, CHEd, Suzanne Drodgee, Eve-Lyne Marchand, BSc, MD, PhD, FRCPCf, Jean-Pierre Bissonnette, PhD, MCCPM, FCOMPb, Erika Browng, Michael Brundage, MDh and Peter Dunscombe, BSc, PhDi a Odette Cancer Centre, Sunnybrook Health Sciences Centre b Department Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre c Canadian Partnership Against Cancer d British Columbia Cancer Agency e Cross Cancer Institute f Hopital Maisonneuve Rosemont g Canadian Partnership for Quality Radiotherapy h Department of Oncology, Queen’s University Queen’s Cancer Research Institute Kingston Regional Cancer Centre i Department of Oncology, University of Calgary Tom Baker Cancer Centre Background: The Canadian Association of Medical Radiation Technologists’ (CAMRT) Standards of Practice provide direction to achieve and maintain the technologist’s contribution to the health care system. In the practice of radiation medicine these Standards provide radiation therapists (RTT) with expectations of performance for practice. One such expectation is that the RTT ‘‘have a quality management responsibility in the application of continuous quality improvement (CQI) principles in all aspects of the profession’’. This can apply at the clinical front lines, at the institutional level, or within the broader Canadian healthcare system. The Canadian Partnership for Quality Radiotherapy (CPQR) was founded in 2010 as an alliance among the national professional organizations involved in the delivery of radiation treatment in Canada: the CAMRT, the Canadian Association of Radiation Oncology (CARO), and the Canadian Organization of Medical Physicists (COMP) together with strategic and financial support from Canadian Partnership Against Cancer (CPAC). The vision and mandate of the CPQR is to support and promote the universal availability of high quality and safe radiotherapy for all Canadians through system performance initiatives aimed at improving quality and mitigating risk. CPQR activities centre on quality improvement, systems performance and knowledge management. The priority areas determined by the CPQR Steering Committee in consultation with clinical practitioners, cancer program leadership, provincial cancer agencies and international collaborators include; Quality assurance guidance and indicators for radiation treatment programs Technical quality control guidance and indicators for radiation treatment equipment A national reporting system for radiation treatment incidents Ensuring that patients are satisfied with the quality and safety of their treatment These program areas were identified as offering the greatest potential to improve quality and safety and mitigate risk. Engaging interprofessional
efforts in these key aspects of cancer care will help improve the quality and safety of radiation treatment in Canada and will reduce the burden of cancer in Canada long-term. Intended Outcomes: 1. Highlight priorities for national quality initiatives over the next 2-5 years, from the perspectives of each of the professional disciplines involved in radiation treatment delivery 2. Provide Radiation Therapists with strategies for interprofessional collaboration in quality assurance. 3. Continue a dialogue within the Canadian Radiation Therapy community regarding quality issues and improvement Structure: Theory (20min); Practical (30min); Review (10min). The format of the theory portion of workshop will specifically highlight opportunities for radiation therapy engagement within the four quality initiative areas of the CPQR. The interprofessional theory discussion will emphasize the collaborative approach the CPQR utilizes to improve the quality and safety of radiation treatment in Canada. The practical portion of workshop will offer Radiation Therapy delegates with the interactive opportunity to; provide feedback on the CPQR quality initiatives and quality concerns (through the use of the audience response system); formulate approaches for further quality improvements and engagement. An Interactive Discussion on the Role of Knowledge Based Planning in the Canadian Radiation Therapy Department Keith Sutherland, RTT, CMD, ACT, CTIC Cancer Care Manitoba Knowledge Based Planning (KBP) is a software tool capable of predicting the dose volume histogram (DVH) of different structures based on their geometric relationship to the target. This previously unavailable information offers an attractive set of possibilities for the Medical Dosimetrist that could improve the planning process. This presentation will discuss KBP and its potential role in the planning process of radiation therapy (RT), and facilitate discussion on the possible uses of this in a Canadian oncology center. RT planning has rapidly evolved in the past 15 years, moving from 2D planning to computer tomography based 3D planning as well as introducing inverse planning. These techniques have improved our ability to deliver conformal dose distributions to the target while sparing the dose to surrounding normal tissues. The quality of the final plan, however, greatly depends on the planning objectives that the software is given, which is in turn dependent on the users experience with the software and treatment site. KBP aims to reduce the effect that user variability has on final plan quality. This is done by using a ‘‘model’’ built with optimal treatment plans as a reference. KBP identifies the relationship between the dose to organs at risk and treatment targets given the relative geometry and departmental planning technique. This information is used to estimate the DVH for each new patient based on past plans with similar characteristics. Furthermore, these estimates can be used to create optimization objectives that will guide the inverse planning process. The use of KBP could benefit staff less experienced with inverse planning, allowing them to achieve plans comparable in quality to those of experienced planners. Experienced planners may also benefit from an initial set of objectives that will yield a plan of high quality, reducing the time and effort required for plan optimization. Additionally, KBP could be used as a tool to quantitatively verify the quality of an RT plan, and as a training tool for new planners. This could translate into improvements in average plan quality, reduction in inter-patient plan variability, improvement in patient throughput, and potentially patient outcomes. Sexual Health Issues in Gynecological Cancer Patients Receiving Radiotherapy: Radiation Therapists’ Role in Technical and Supportive Care Angela S. Turner, MRT(T), MHSca and Kitty Chan, Hon BSc, MHSc, MRT(T)b a Odette Cancer Centre b Princess Margaret Cancer Centre
Conference Proceedings from RTi3 2014/Journal of Medical Imaging and Radiation Sciences 45 (2014) 162-188
187