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Using Quantitative Data to Improve and Maintain Metrics of Quality and Safety in Radiation Therapy

P Xia1*, N Yu1 , E Murray1 , T Meier1 , P Barrett1 , D LaHurd1 , S Chao1 , J Suh1 , (1) The Cleveland Clinic Foundation, Cleveland, OH,


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: : To report the use of quantitative data to improve and maintain quality and safety in the radiation therapy process.

Methods: The process of radiation therapy is complex and requires different teams working closely together. We identified three metrics for improvement since 2011: the rate of late non-urgent new plan completions (4 hours prior to the first appointment), the percent of missing weekly chart checks, and the rate of daily treatment couch parameter overrides. For each of these metrics, we set the goal of achieving < 5% for each metric. To help manage these metrics, we developed an in-house program based on the EMR system to provide daily alerts about pending tasks and daily/monthly/quarterly reports about these metrics.

Results: Although the monthly average of non-urgent new plans increased from 171 in 2015 to 243 in 2018 and the monthly average treatment sessions increased from 3409 in 2015 to 3751 in 2018, we made improvements in all three metrics. We were able to improve the number of months meeting the goal of the late new plan completions (2 months in 2015, 5 in 2016, 9 in 2017, and 11 in 2018). The number of months meeting the of missing weekly chart checks was 8 in 2015, 9 in 2016, 6 in 2017, and 12 in 2018. The number of months meeting the goal for daily overrides was 11 in 2015, 12 in 2016, 8 in 2017, and 12 in 2018. The increased rates of missing weekly chart checks and daily overrides in 2017 were a result of replacing five out of six linear accelerators when we moved into a new cancer center building.

Conclusion: By using objective quantitative metrics and frequently measuring these objectives, the radiation therapy process can improve by driving all teams to achieve set goals.


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