The Timeliness Initiative: Continuous Process Improvement for Prompt Initiation of Radiation Therapy Treatment.
The Timeliness Initiative: Continuous Process Improvement for Prompt Initiation of Radiation Therapy Treatment.
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DOI：
10.1016/j.adro.2020.01.007
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发表时间：
2020-09
影响因子：
2.3
通讯作者：
Steinberg M
中科院分区：
文献类型：
--
作者：
Agazaryan N;Chow P;Lamb J;Cao M;Raldow A;Beron P;Hegde J;Steinberg M
门诊病人的体验在很大程度上受到等待提供者护理时间的影响。延迟的患者就诊开始时间可能会对总体满意度产生负面影响，而增加的等待时间会影响对卫生保健提供者提供的信息、指示和治疗的感知。全面改进机构实践需要确定基本的质量度量标准，使这一成就成为可能。在开始放射治疗之前的长时间可能会导致患者和转诊提供者的满意度和护理质量下降，这可能会对患者接受放射治疗造成障碍。本机构试点并成功完成了一项研究，旨在提高患者放射治疗的及时性。这项工作旨在确定放射治疗计划的低效率，以缩短每位患者等待治疗的时间。我们检查了模拟到第一部分治疗开始之间的时间。这一阶段包括模拟、轮廓、治疗计划和计划的质量保证。在研究之前，计划过程通常需要两周的时间。靶器官和高危器官轮廓是延迟治疗开始日期的主要无效因素。这种描绘过程包括在放射学图像上绘制轮廓，通常是计算机断层扫描和磁共振成像。我们专注于完成轮廓加工所需的时间，并采取措施提高效率。从模拟到轮廓批准的时间缩短了60%以上，从平均超过4天减少到不到1.5天。总体规划时间从2周缩短到5天以内。流程改进和特定任务工具的实施提高了患者治疗的及时性，将从模拟到治疗的总体规划时间缩短到5天以内。对这些过程的持续监测和修改表明，在提高护理质量方面取得的成功是持续的。
The ambulatory patient experience is heavily influenced by wait times for provider care. Delayed patient visit start times may negatively affect overall satisfaction, and increased wait times affect the perception of the information, instructions, and treatment given by health care providers. Improving institutional practices overall requires the determination of the essential quality metrics that will make such an achievement possible. A protracted time leading up to the initiation of radiation therapy may promote poor satisfaction and perceived quality of care for both patients and referring providers alike, which may then create a barrier to patients being treated with radiation therapy. This institution piloted and sucessfully completed a study into improving the timeliness of initiation of patient radiation therapy for our patients. This work sought to identify inefficiencies in radiation therapy treatment planning to shorten the time each patient waited for treatment. We examined the time between simulation to the start of the first fraction of treatment. This period includes simulation, contouring, treatment planning, and quality assurance of the plan. Before the study, the planning process would typically take 2 weeks. Target and organs-at-risk contouring were found to be the main inefficiency delaying treatment start dates. This delineating process includes drawing contours on radiologic images, typically computed tomography and magnetic resonance imaging. We focused on the time needed for the contouring process to be completed and took steps to increase efficiency. The length of time from simulation to contour approval was decreased by more than 60%, a reduction from an average of more than 4 days to less than 1.5 days. Overall planning time dropped from 2 weeks to less than 5 days. Process improvements and implementation of task-specific tools improved the timeliness of patient treatments, reducing the overall planning time from simulation to treatments to less than 5 days. Continuous monitoring and modification of these processes revealed that the successes achieved toward better quality of care have been sustained.
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影响因子：
3.9
作者：
Abdel-Rahman, Omar
通讯作者：
Abdel-Rahman, Omar
影响因子：
5.7
作者：
Gomez, Daniel R.;Liao, Kai-Ping;Smith, Benjamin D.
通讯作者：
Smith, Benjamin D.
影响因子：
2.8
作者：
Victoor A;Delnoij DM;Friele RD;Rademakers JJ
通讯作者：
Rademakers JJ
影响因子：
1.1
作者：
Bullard JT;Eberth JM;Arrington AK;Adams SA;Cheng X;Salloum RG
通讯作者：
Salloum RG
影响因子：
6.2
作者：
Ho, Allen S.;Kim, Sungjin;Zumsteg, Zachary S.
通讯作者：
Zumsteg, Zachary S.