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Author Spotlight: Improving Radiation Therapy Access with Radiation Planning Assistant
Published on: October 6, 2023
Quality improvement in paediatric radiation oncology through peer review
Laura Murphy1, Jessica Cantwell1, Jennifer Chard1
1Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia.
Insights
A videoconference for pediatric radiation oncologists in Australia and New Zealand (ANZ) can improve patient care. The meeting, held fortnightly, recommended management changes for 13% of pediatric radiation therapy cases reviewed.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Clinical Audit
Background:
- Approximately 300 children in Australia and New Zealand (ANZ) receive radiation treatment (RT) annually.
- A videoconference for radiation oncologists managing pediatric patients commenced in 2013.
- This audit assessed the videoconference's impact on pediatric RT care in ANZ.
Purpose of the Study:
- To audit a fortnightly videoconference for pediatric radiation oncologists in ANZ.
- To evaluate the videoconference's influence on the management of children receiving RT.
- To identify potential improvements for pediatric RT services.
Main Methods:
- Retrospective analysis of de-identified videoconference minutes from August 2013 to December 2019.
- Data categorized into meeting participation, case presentations, and management decisions.
- Audit focused on meeting frequency, attendance, case discussion timing, and treatment plan modifications.
Main Results:
- 119 meetings were held, discussing 334 pediatric patients over six years.
- Most cases (80%) were discussed before RT initiation.
- Management plan changes were recommended for 13% of patients, with 8% of RT plans adjusted.
Conclusions:
- Increasing meeting frequency to weekly could allow review of all pediatric RT patients prior to treatment.
- The videoconference is crucial for maintaining expertise in pediatric RT and can serve as a proton therapy referral panel.
- Enhancements could lead to changes in RT management for up to 13% of children annually.
Introduction:
Around 300 children in Australia and New Zealand (ANZ) undergo a course of radiation treatment (RT) each year. A fortnightly videoconference for radiation oncologists managing children started in 2013. We conducted an audit of the videoconference to assess its influence on the care of children who receive RT in ANZ.
Methods:
De-identified data from minutes (August 2013-December 2019) were analysed retrospectively using three categories: meeting participation, case presentations and management decisions.
Results:
There were 119 meetings and 334 children discussed over the six-year audit period with regular attendance from four of 11 centres treating children in ANZ. Most cases (80%) were discussed prior to RT. A change in the overall management plan was recommended for around one in eight patients (35/334, 13%). RT plan reviews were performed in 79 cases (23%). Adjustments were made to the target volume contours or treatment plan in 8% (6/79).
Conclusion:
Increasing the frequency of the meeting to weekly and compliant with the RANZCR Peer Review Audit Tool has the capacity to review all paediatric RT patients in ANZ prior to RT and initiate changes for as many as one in eight children treated by RT each year. The meeting should be considered a core component necessary to maintain expertise in paediatric RT in all centres providing RT for children in ANZ while also acting as a proton referral panel as more children are referred abroad for proton therapy before the Australian Bragg Centre for Proton Therapy opens in Adelaide in 2024.
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