Enhancing clinical effectiveness of pre-radiotherapy workflow by using multidisciplinary-cooperating e-control and e-alerts: A SQUIRE-compliant quality-improving study.

Autor: Lin YH; Departments of Radiation Oncology, Section of Chest Medicine Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Department of Radiation Oncology, Buddhist Tzu Chi General Hospital School of Medicine, Tzu Chi University, Hualien Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei Institute of Molecular Biology, National Chung Cheng University, Min-Hsiung, Chia-Yi, Taiwan, ROC., Hung SK, Lee MS, Chiou WY, Lai CL, Shih YT, Yeh PH, Lin YA, Tsai WT, Hsieh HL, Chen LC, Huang LW, Lin PH, Liu DW, Hsu FC, Tsai SJ, Liu JC, Chung ES, Lin HY
Jazyk: angličtina
Zdroj: Medicine [Medicine (Baltimore)] 2017 Jun; Vol. 96 (24), pp. e7185.
DOI: 10.1097/MD.0000000000007185
Abstrakt: Radiotherapy (RT) is useful in managing cancer diseases. In clinical practice, early initiation of RT is crucial for enhancing tumor control. But, delivering precise RT requires a series of pre-RT working processes in a tight staff-cooperation manner. In this regard, using information system to conduct e-control and e-alerts has been suggested to improve practice effectiveness; however, this effect is not well defined in a real-world RT setting.We designed an information system to perform e-control and e-alerts for the whole process of pre-RT workflow to shorten processing time, to improve overall staff satisfaction, and to enhance working confidence.A quality-improving study conducted in a large RT center.Externally validated data were retrospectively analyzed for comparison before (from Sep. 2012 to Dec. 2012, n = 223) and after (from Sep. 2013 to Dec. 2013, n = 240) implementation of pre-RT e-control and e-alerts.Applying the e-control with delay-working e-alerts in pre-RT workflow was the main intervention.Nine workstations were identified in pre-RT workflow. The primary outcome measure was the processing time in each pre-RT workstations before and after implementing the e-control and e-alerts. Secondary measures were staff-working confidence and near-missing cases during the process of pre-RT workflow.After implementing e-control, overall processing time of pre-RT workflow was shortened from 12.2 days to 8.9 days (P < .001). Follow-up data (till Jul. 2016) showed a durable effect of 9.2 days, being still below the predefined threshold of <10 days.Using a multidisciplinary-cooperating information system is useful to conduct e-control and e-alerts in the whole process of pre-RT workflow. Clinical effectiveness, staff satisfaction, and working confidence are able to be enhanced obviously.
Databáze: MEDLINE