Radiotherapy outpatient review: a nurse-led clinic

The aim of this project was to improve the quality of the delivery of care to patients undergoing outpatient fractionated radiotherapy, in terms of effectiveness and efficiency. This article provides a descriptive account of the activities that took place within a traditional doctor-held radiotherapy review (floor) clinic (71 individual clinic episodes from 71 patients) and compares them with a nurse-led clinic (299 clinic episodes from 141 patients). The outcome measures encompassed the number and type of activities in both clinics, including the number of interventions that occurred, consultation time, waiting time, degree of involvement with other support services, reasons for doctor contact, and perceptions of patients, doctors, nurses and therapy radiographers. Nurse consultations lasted longer than doctor consultations. Waiting times were reduced. Of 299 nurse-led clinic episodes, only 21 contacts were made with the doctor. More interactions and activities occurred during nurse consultations. A greater number of referrals and liaisons with other support services occurred, resulting in the establishment of continuity of care. The results from this small sequential observational study require prospective confirmation, but they suggest that specialist nursing staff, given appropriate medical support, may provide more effective care for patients who are undergoing outpatient radiotherapy.