Thinking Differently About the Kids: An Innovative Approach to Improve Care Provided to Pediatric Patients Undergoing External Beam Radiation Therapy

This article reports the changes made from 2009-2012 to the external beam radiation therapy (EBRT) preparation and treatment process provided to pediatric patients at the Tom Baker Cancer Center (TBCC) Calgary, Alberta, Canada.

The number of pediatric patients referred for EBRT at the TBCC doubled between the years 2008 (15 patients) and 2011 (30 patients). This increase in patient numbers prompted the staff of radiation therapists to evaluate the department's EBRT preparation and treatment process for pediatric patients.

A literature search was performed to obtain data and research findings that described pediatric care processes adopted by EBRT programs in Canada and other countries. A pediatric working group (PWG) was assembled at the TBCC, which identified two areas for internal review and evaluation. The PWG critically reviewed the process of determining the delivery of treatment under sedation versus nonsedation and reviewed and evaluated the current play therapy and educational tools used to reduce the anxiety of children and parents concerning EBRT.

The presence of a radiation therapist at each new patient pediatric consult resulted in positive effects in the management of the patient's journey through EBRT. The application of the Pediatric Care Pathway Assessment Tool at the time of consult helped to identify patients requiring sedation versus nonsedation for treatment. The implementation of play therapy sessions before the start of treatment in combination with the use of audiovisual aids during EBRT reduced the requirement of sedation for treatment. A time motion log was found to be an appropriate tool for measuring the amount of time a patient spends in the department and helped to validate the placement of the patient on the sedation or non-sedation pathway.