ESTRO 2022 - Abstract Book

S883

Abstract book

ESTRO 2022

The architecture and built environment of radiotherapy departments is a prerequisite for treatment. The implementation of evidence-based design in health care settings can positively influence workflow, travel paths, well-being and quality of stay. This study establishes spatial criteria and typologies of cluster formations and room organization by analyzing floorplans of radiotherapy departments in German hospitals. Materials and Methods In order to obtain insight into the space requirements of radiotherapy departments the following procedures have been pursued. For developing typologies and planning requirements a comparative floorplan-analysis of 25 radiotherapy departments in Germany was conducted. Given the complexity of radiotherapy departments, a list of rooms was composed and categorized into cluster. The cluster-formations were further analyzed by their relation, distance and arrangement towards each other. The analysis was inspecting differences and similarities in patterns of spatial relationship of cluster and rooms. In addition, the comparability of different sized departments, measured by the number of therapy rooms, was investigated. Results With this comparative floorplan-analysis a classification of radiotherapy departments on the basis of organizational and spatial characteristics was developed. 6 cluster-formations were conducted: Outpatient, Imaging, Planning, Therapy, Personnel and Service with each dedicated rooms. Typologies and spatial characteristics were derived and visualized. Conclusion The comparative analysis of floorplans shows a spectrum of built environment and cluster arrangements, which lead to typologies and planning requirements. Further research will be conducted by combining these typologies with workflow, individual travel paths, environment behavior and requirements of all user groups and expert knowledge. With this multilayered study, design recommendations for planning radiotherapy departments can be identified. 1 Maastricht University, Department of Radiation Oncology (MAASTRO), Maastricht, The Netherlands; 2 Lillebaelt Hospital – University Hospital of Southern Denmark, Department of Oncology, Vejle, Denmark; 3 Lillebaelt Hospital – University Hospital of Southern Denmark, Center for Shared Decision Making, Vejle, Denmark Purpose or Objective Shared decision-making (SDM) is the collaboration between patients and clinicians to make clinical decisions based on evidence and patient preferences, often supported by patient decision aids (PDAs). This study explored Danish practitioners’ experiences in a clinic where SDM has been successfully implemented. The aim was to identify success factors according to practitioners. Materials and Methods We used a qualitative approach to examine the experiences of 10 practitioners with a clinical background who were involved in the SDM initiative, e.g. practicing oncologists, nurses, team leaders, and researchers. Semi-structured interviews focused on: (i) participants’ experiences with usual care and initial impressions of the SDM paradigm; (ii) experiences of SDM training; (iii) using paper-based PDAs in practice; (iv) challenges of putting SDM into practice; (v) effects of SDM on the consultation process and outcomes; (vi) implementation success factors and remaining challenges. Interview transcripts were analyzed with thematic analysis, a reflexive method for coding and identifying patterns in qualitative data. Results The full thematic map of our findings is given in Fig. 1. Prior to SDM implementation, participants’ attitudes were roughly evenly distributed between skeptical and receptive. Those with more direct long-term contact with patients (such as nurses) were more positive about the need for SDM. 1. Raising clinician awareness of SDM behaviors: prior to SDM implementation, the level of patient involvement was measured using the OPTION-12 scale. Patients and clinicians also participated together in PDA development. These two factors made clinicians aware of the gap between current practice and an ideal SDM process. 2. Reinforcement: clinicians used in-consultation paper PDAs structured according to a 5-step SDM model. These structured PDAs helped reinforce the SDM steps so that new habits could be sustained. 3. Flexibility: an online platform was created, with generic PDA templates that could be customized by clinicians, giving them flexibility to apply SDM in different clinical contexts. 4. Leadership: Strong leadership was instrumental in driving these changes, beginning with a clear strategic vision, ongoing communication with clinicians, and empowering them to lead SDM training through a Train-the-trainer teaching format. We identified four main themes for successful SDM implementation: PO-1048 Practitioners’ views on shared decision-making implementation: A qualitative study A. Ankolekar 1 , K. Dahl Steffensen 2 , K. Olling 3 , A. Dekker 1 , L. Wee 1 , C. Roumen 1 , H. Hasannejadasl 1 , R. Fijten 1