ESTRO 2024 - Abstract Book

S2954

Interdiscplinary - Other

ESTRO 2024

Treatment with a personalised technical approach requires full multidisciplinary team (MDT) involvement, and as such it was critical to engage with stakeholders early to establish the key aims in changing the current process. The key stakeholders were identified as Clinician representation (governance and technical development); pre treatment, treatment and R&D radiographer leads; technical development and operational physics leads; radiotherapy services quality manger. Out of this engagement the main aims of the workflow identified were

• Record all information directly in clinical system. • Off protocol techniques to have superintendent and MPE oversight • Auto notification to relevant staff • Formalise authorisation of non-standard exposures. • All above to be auditable in a single report.

b) Development of process

With the key aims established a questionnaire and group assigned tasks were identified as the best tools within ARIA to use. A test process was established in the research OIS. This included a questionnaire to capture relevant information, creation of an ARIA group ‘ off protocol group (OPG) group’ containing all relevant staff, i.e. superintendent radiographer staff and MPEs, a task to notify this group, Encounter items to aid completion and visualisation of the questionnaires and tasks.

c) Presentation and feedback from stakeholders

Feedback from the stakeholders was positive with some minor suggestions that were incorporated into the final workflow. At this stage engagement was sought from the AURA physicist to enable streamlined reporting within ARIA once in clinical use.

d) Implementation

The process was transferred to the clinical system and the department informed of the switch over date. Patients who were using the old form system but were within the treatment pathway were manually identified and transferred to the new system so department processes still highlighted them as ‘off protocol’.

Results:

Figure 1 below shows the implemented workflow. All patients referred for radiotherapy are discussed in site specific pre-planning meeting (PPM). This is an MDT consisting of clinician, radiographer, and dosimetrist or physicist. Any patient requiring an off-protocol technique is now highlighted at this stage, with the relevant information recorded in the questionnaire and an off-protocol task added. Once the task has been added it appears on the task list for the off-protocol group. Members of the group are responsible for reviewing requested technique and advising where appropriate. Any non-standard exposures can be authorised here by the UK IRMER defined practitioner (UK ionising radiation medial exposure regulations).