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An Internal Quality Improvement Portal Mimicking ROILS Shows Variations in Utilization and Reporting

A Harrison*, L Doyle , L Babinsky , M Hurwitz , M Werner-Wasik , Sidney Kimmel Cancer Center at Thomas Jefferson University Hospital, Philadelphia, PA


(Sunday, 7/14/2019)  

Room: ePoster Forums

Purpose: Our institution participates in the Radiation Oncology Incident Learning System(ROILS); however, rapid network expansions, legal relationships and staggered harmonization are barriers to implementing ROILS across our enterprise. An internal quality improvement portal(QIP) was created to provide clinical details, ease of access and database ownership, while mimicking ROILS formatting. This study compares the data from the first year of QIP to ROILS.

Methods: First year QIP data is summarized and compared to ROILS Aggregate Report Q1-Q2 2018(ROILS-AG) from 425 potential institutions. Variations in overlapping QIP/ROILs categories, “Event Types�, “Where Events are Discovered�, “Where Events Occur� and “Event Reporters�, are explored.

Results: A comparison of the type of events, point at which the events were discovered, where the event occurred and the event reporters yielded differences in all categories between ROILS-AG and QIP. Process improvement, near miss and therapeutic radiation incidents had the greatest (ROILS-AG)-QIP net differences(-31%,19%,17% respectively) for “Event types�. “Where Events Were Discovered� showed a downstream shift in RT workflow for the QIP as compared to the ROILS-AG data and a larger percentage of QIP reports occurring outside of the RT workflow and related to equipment/software. “Event Reporters� were similar with physicists and therapists as highest reporters(75% of QIPs to 67% ROILS-AG). QIP had 10% higher physician and 5% higher nursing reporting than ROILS-AG.

Conclusion: Comparing our institutional internal reporting system to the national aggregate reporting system in the types of events, where and by whom events were reported as well as where events occurred all provide valuable information to evaluate how the QIP is being utilized, gauge buy-in from different teams and highlight events that occur outside of the RT workflow. Further work will identify potential areas of overlap between the systems and the utilization of one or both systems in an academic radiation oncology network of institutions.


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