Data Driven Management Using Quantitative Metric and Automatic Auditing Program (QMAP) Improves Consistency of Radiation Oncology Processes

Publication date: Available online 24 October 2016
Source:Practical Radiation Oncology
Author(s): Naichang Yu, Ping Xia, Anthony Mastroianni, Matthew D. Kolar, Samuel T. Chao, John F. Greskovich, John H. Suh
PurposeProcess consistency in planning and delivery of radiotherapy is essential to maintain patient safety, and treatment quality and efficiency. Ensuring the timely completion of each critical clinical task is one aspect of process consistency. The purpose of this work is to report our experience in implementing a quantitative metric and automatic auditing program (QMAP) with a goal of improving the timely completion of critical clinical tasks.Materials and MethodsBased on our clinical electronic medical records (EMR) system, we developed a software program to automatically capture the completion time-stamp of each critical clinical task while providing frequent alerts of potential delinquency. These alerts were directed to designated triage teams within a time window that would offer an opportunity to mitigate the potential for late completion. Since July 2011, 18 metrics were introduced in our clinical workflow. We compared the delinquency rates for 4 selected metrics before the implementation of the metric with the delinquency rate of 2016. Student t-test with one tail was used for statistical analysis.ResultsWith an average of 150 daily patients on treatment at our main campus, the late treatment plan completion rate and late weekly physics check (WPC) were reduced from 18.2% and 8.9% in 2011 to 4.2% and 0.1% in 2016, respectively (p<0.01). The late weekly on-treatment physician visit rate was reduced from 7.2% in 2012 to <1.6% in 2016. The yearly late CBCT review rate was reduced from 1.6% in 2011 to <0.1% in 2016.ConclusionsQMAP is effective in reducing late completions of critical tasks, which can positively impact treatment quality and patient safety by reducing the potential for errors resulting from distractions, interruptions, and rush in completion of critical tasks.



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