Kalet Alan M, Kim Minsun, Hendrickson Kristi R G, Cao Ning, Young Lori, Fang Christine L, Kim Janice, Landers Angelia, Lavilla Myra A, Meyer Juergen
Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America; Department of Radiation Oncology, Seattle Cancer Care Alliance, Seattle, WA, United States of America.
Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America.
Phys Med. 2022 Sep;101:62-70. doi: 10.1016/j.ejmp.2022.08.003. Epub 2022 Aug 11.
One of the common challenges in delivering complex healthcare procedures such as radiation oncology is the organization and sharing of information in ways that facilitate workflow and prevent treatment delays. Within the major vendors of Oncology Information Systems (OIS) is a lack of tools and displays to assist in task timing and workflow processes. To address this issue, we developed an electronic whiteboard integrated with a local OIS to track, record, and evaluate time frames associated with clinical radiation oncology treatment planning processes.
We developed software using an R environment hosted on a local web-server at Seattle Cancer Care Alliance (SCCA) in 2017. The planning process was divided into stages, and time-stamped moves between planning stages were recorded automatically via Mosaiq (Elekta, Sweden) Quality Check Lists (QCLs). Whiteboard logs were merged with Mosaiq-extracted diagnostic factors and evaluated for significance. Interventional changes to task time expectations were evaluated for 6 months in 2021 and compared with 6 month periods in 2018 and 2019.
Whiteboard/Mosaiq data from the SCCA show that treatment intent, number of prescriptions, and nodal involvement were main factors influencing overall time to plan completion. Contouring and Planning times were improved by 2.6 days (p<10) and 2.5 days (p<10), respectively. Overall time to plan completion was reduced by 33% (5.1 days; p<10).
This report establishes the utility of real-time task tracking tools in a radiotherapy planning process. The whiteboard results provide data-driven evidence to add justification for practice change implementations.
在提供诸如放射肿瘤学等复杂医疗程序时,常见的挑战之一是以促进工作流程并防止治疗延迟的方式组织和共享信息。肿瘤学信息系统(OIS)的主要供应商缺乏协助任务计时和工作流程的工具及显示功能。为解决此问题,我们开发了一个与本地OIS集成的电子白板,以跟踪、记录和评估与临床放射肿瘤治疗计划流程相关的时间框架。
2017年,我们在西雅图癌症护理联盟(SCCA)的本地网络服务器上使用R环境开发了软件。计划流程被划分为多个阶段,通过Mosaiq(瑞典医科达公司)质量检查表(QCL)自动记录计划阶段之间带时间戳的变动。白板日志与从Mosaiq提取的诊断因素合并,并进行显著性评估。2021年对任务时间预期的干预性变化进行了6个月的评估,并与2018年和2019年的6个月时间段进行比较。
SCCA的白板/Mosaiq数据显示,治疗意图、处方数量和淋巴结受累情况是影响总体计划完成时间的主要因素。轮廓绘制时间和计划时间分别缩短了2.6天(p<0.1)和2.5天(p<0.1)。总体计划完成时间减少了33%(5.1天;p<0.1)。
本报告确立了实时任务跟踪工具在放射治疗计划流程中的效用。白板结果提供了数据驱动的证据,为实践变革的实施增添了合理性依据。