ESTRO 38 Abstract book

S101 ESTRO 38

were distributed to the multi-disciplinary clinical team following each phase. Results Over both phases, 312 patients (46% breast, 18% upper gastrointestinal, 36% head and neck) were treated in the new organizational model. On average, 75% of a patient’s priority points-of-care were delivered by the primary RT in the new model, compared to 40% in the standard model. Overall, of the 173 patients surveyed, ≥95% of were satisfied with their experience. Compared to the fragmented standard model, 20% more patients in this model were satisfied with the patient education information they received and with staff consistency. Among the patients diagnosed with Breast cancer, 30% fewer reported accessing ‘drop-in’ nursing support clinics relative to the standard fragmented model. Multi- disciplinary stakeholders (n=83) saw improvements in patient support as a substantial benefit of the new model, with workflow challenges identified as a potential implementation barrier. Conclusion A patient-focused organizational model was developed to partner individual RTs with patients throughout their radiotherapy course. It was feasible to accrue substantial numbers of patients to this model. These early results suggest improved continuity of care, high quality supportive care and patient experience. Full-scale implementation of this organizational model is currently underway in our large comprehensive cancer centre. OC-0196 Predictors for radiation-induced oesophagitis in breast cancer patients K. West 1 , M. Schneider 2 , C. Wright 2 , R. Beldham- Collins 1,3 , N. Coburn 3 , K. Tiver 3 , V. Gebski 4 , K. Stuart 1,5,6 1 Crown Princess Mary Cancer Centre, Westmead Hospital, Wentworthville, Australia; 2 Monash University, Department of Medical Imaging and Radiation Sciences- Faculty of Medicine- Nursing and Health Sciences, Clayton, Australia ; 3 Nepean Cancer Care Centre, Nepean Hospital, Penrith, Australia; 4 NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia ; 5 Breast Cancer Institute, Westmead Hospital, Westmead, Australia; 6 Sydney Medical School, The University of Sydney, Sydney, Australia Purpose or Objective Radiation therapy (RT) for early breast cancer is increasingly more personalised. Treatment using intensity-modulated RT (IMRT) to the supraclavicular (SCF) nodes has shown potential for development of oesophagitis. This pilot study aims to identify predictors for the onset of radiation-induced oesophagitis. Material and Methods Patients prescribed RT to the breast or chest wall and SCF nodes (± other nodal groups) to a dose of ≥ 50 Gy) in 25 fractions were considered eligible for the study. Patients were recruited consecutively at the time of simulation, and only excluded if they had previous treatment to the ipsilateral breast or chest wall or other contraindications to RT. A hybrid IMRT planning technique with a minimum of 95% of the prescribed dose to cover all PTVs was utilised for all patients. Grading was undertaken twice weekly using the RTOG system to determine the onset of moderate oesophagitis (grade 2). Mean and maximum doses to the oesophagus were recorded, as well as oesophageal length and length of pharynx included in the treatment area. Demographic data including age, treatment areas (SCF, internal mammary chain (IMC), axilla), laterality of disease site, chemotherapy and smoking history were recorded. Data were analysed using Fishers exact test and GraphPad Prism software with a 0.05 significance level. Results A total of 77 patients were enrolled from September 2012 until July 2015. Twenty-four patients reported a maximum

poor communication about them were also reported through undesirable events. In the registered complaints, we found as concordance, a delay and a lack of communication about treatment and a problem of relationship with the Radiation Therapist staff. These common items have been chosen as events on which the RT department will implement improvement actions in priority (Figure1).

Conclusion By crossing these 3 information channels, we were able to highlight some areas on which we can reinforce improvement in order to increase patients’ satisfaction as well as quality and safety of their care. This allows us to actively involve patient in quality processes of RT department so that he becomes a key actor in quality and safety of its own treatment. To continue this process of continuous improvement, a new crossover of these information will be organized at regular intervals. Our final goal is to strengthen the quality and safety of treatments to create value for the patient and improve the patient experience. And it’s to adjust treatments to the life project of the patient and promote a participative approach focused on the patient’s needs and expectations. OC-0195 Towards a Patient-Focused Organizational Model for Radiation Therapists A. Shessel 1 , E. Moyo 1 , A. Koch 1 , J. Ringash 1 , J. Waldron 1 , F.F. Liu 1 , M. Velec 1 1 Princess Margaret Cancer Center, Radiation Medicine Program - Radiation Therapy, Toronto, Canada Purpose or Objective Patient experiences over their course of radiotherapy journey are fragmented by the many interactions from different Radiation Therapists (RTs), each focused on specific supportive care / technical activities (e.g. simulation, planning, delivery, etc.). The aim of this project was to determine the feasibility of reorganizing to provide continuity of care by identifying a primary RT partnering with each patient, throughout their entire Two 4-month pilots were conducted in a single department (proof-of-concept phase in 2017, feasibility phase in 2018), with 16 RTs working in the new organizational model. Patients were triaged into the new model based on technique complexity or a perceived need for added psychosocial support (e.g. high anxiety, non- English speaking). Each patient was partnered with a ‘primary’ RT. This RT performed, all point–of-care activities identified as high priority (critical activities/time-points in the treatment course) for their patients as often as scheduling permitted. The high priority points-of-care were: all education and supportive care activities (including a new pre-treatment session and a new 2-week post treatment follow-up call), CT- simulation, dosimetry review, peer-review rounds and treatment delivery (at least 1st and last fractions). All ‘primary’ RT activities were documented to assess continuity of care. Patient satisfaction surveys were distributed at the final treatment and stakeholder surveys radiotherapy trajectory. Material and Methods