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Radiotherapy Programs

The Clinician’s Guide to Radiation Oncology

The Faculty of Radiation Oncology at The Royal Australian and New Zealand College of Radiologists have developed a guide to assist medical practitioners understand the role and use of radiotherapy. The Guide covers each of the common tumour sites, paediatrics, oncological emergencies as well as explaining the common side-effects of radiotherapy and their management The guide can be found here: http://www.ranzcr.edu.au/faculty/about/clinicians_guide.cfm.

Radiotherapy Business Process Improvement Program 2006

The Cancer Institute NSW and NSW Health have begun work on the Radiotherapy Business Process Improvement Program. The genesis of this program has arisen from the outcomes of the Radiotherapy Collaborative Workshop held in March 2005.

Individual projects examining local issues will be conducted in each public NSW radiation oncology treatment centre. External consultants engaged by the Cancer Institute NSW will work directly with local teams to identify opportunities for improvement in business practices and service delivery; and then to implement change to take advantage of these opportunities.

The findings and learnings from these local projects will be shared statewide using a collaborative methodology. The establishment of a Radiotherapy Collaborative will facilitate dissemination of findings and outcomes; and gain the support of the State's radiotherapy departments for quality improvement initiatives

Outcomes of this Program will be evaluated against a set of baseline measures, key performance indicators and other qualitative measures.

Local and Statewide key performance indicator baseline measures will be derived from existing indicators and through interaction with the contracted consultant and the radiation oncology community.

Outcomes for patients and their carers will include:

• increased access to radiotherapy services;
• reduced waiting times;
• increase in percentage of patients treated to established benchmarks for care;
• better systems to improve business practices and service delivery through a greater customer focus; and
• a more streamlined approach to radiation therapy treatment to minimise the number of separate appointments, patient waiting time and number of contacts.

Outcomes for clinicians and staff will include:

• improved patient flow resulting from improved processes and systems;
• development of a team approach to issue identification and resolution;
• increased professional development opportunities; and
• more viable business processes and increased revenue streams;

Outcomes for the Cancer Institute NSW and NSW Department of Health will include:

• improved access to radiotherapy services in NSW;
• increased business efficiency in Radiation Oncology Treatment Centres;
• a sustainable, system wide mechanism(s) for improved service delivery;
• facilitation of skills transfer in and between Radiation Oncology Treatment Centres;
• improved communication between individual Radiation Oncology Treatment Centres and with the Cancer Institute NSW and the NSW Department of Health;
• enhanced capacity with less duplication and frustration;
• increased patient satisfaction;
• contribution to development of Radiotherapy Collaborative program; and
• development of generic business plans and models for service.

Collaboratives & Organisational Process Review in Radiotherapy

The Cancer Institute NSW and the NSW Department of Health convened a half-day workshop on 4 March 2005 to bring together representatives from NSW Radiation Oncology Facilities, Quality Improvement Experts, Health Service Planners and the Joint Radiotherapy Working Party to discuss the establishment of collaboratives in radiotherapy.

The purpose of the workshop was to provide background on quality programs and collaboratives undertaken in radiotherapy; to assist radiotherapy departments to undertake quality improvement programs; collaborate to facilitate dissemination of findings and outcomes; and to gain the support of the State's radiotherapy departments for quality improvement initiatives and the establishment of regular state-wide collaborative meetings.

The outcomes of the workshop will direct the Cancer Institute NSW on how best to proceed with the implementation of Program 16.3 of the NSW Cancer Plan 2004 – 2006, the Quality improvement in radiotherapy program. The stated outcome of Program 16.3 is to identify improvements in the operational practice of radiotherapy programs and move towards the benchmark rate of 52% of all diagnosed cancer patients receiving radiotherapy.

A report providing a summary of the workshop discussions and findings will be posted on the website soon. During the workshop a series of presentations were made. The slides of these presentations are available here:

• Workshop Program [pdf]

Powerpoint Presentations

• Workshop Slides [ppt] developed and presented by Ms Jennifer Schofield and Ms Julianne Anderson, Schofield Consultancy.
• Breakthrough Series Collaboratives: A System Wide Approach to Improving Clinical Service Delivery [ppt]
  Guest Presentation by Ms Lorraine McEvilly, Clinical Excellence Commission
• Radiation Therapists' Role Re-Appraisal, 1999 – 2000 Radiation Oncology Network Nepean And Westmead [ppt]
  Guest Presentation by Dr Colin Bull Director Radiation Oncology Network, Westmead and Nepean Hospitals
• QI in Radiation Therapy: You don't have to climb Everest!![ppt]
  Guest Presentation by Ms Marianne Rinks, Chief Radiation Therapist, Sydney Radiotherapy & Oncology Centre
• Where to From Here[ppt]
  A presentation providing some suggestions on what topics a Collaborative in Radiation Oncology may focus on. Presented by Matthew Mikus-Wellings, Cancer Institute NSW.

Following the outcomes of the Radiotherapy Collaborative Workshop the Cancer Institute NSW has set up and hosts a listserver open to anyone interested in receiving information about Radiotherapy Collaborative activities and projects.

To receive information about Radiotherapy Collaboratives please send an email to: majordomo@lists.health.nsw.gov.au and type: subscribe radiotherapy in the body (not the subject) of the email.

For further information, please email Matthew Mikus-Wellings, Project Officer, Radiotherapy - Cancer Institute NSW, via info@cancerinstitute.org.au or ph: 02 8374 5600.

The Cancer Institute NSW will be evaluating the outcomes and suggestions from this workshop and developing further the idea of Collaboratives in both radiotherapy and other cancer services.

Other Information on Collaboratives

The NSW Department of Health in collaboration with the Clinical Excellence Commission has developed a comprehensive library of information on Collaboratives in NSW in Chronic Care. An overview of the NSW Department of Health Collaborative methodology for Patient Flow and Safety, and Chronic Care can be found here.

Other comprehensive sources of information on Collaboratives include the UK National Health Service. The Cancer Services Collaborative home page is a good source of information, as is the specific Radiotherapy Collaborative Program . The Radiotherapy Toolkit is a particularly good example of how to run a Collaborative in Radiotherapy as well as suggestions for projects.

Radiotherapy Joint Working Party

The Radiotherapy Joint Working Party has been established by the Cancer Institute NSW and the NSW Department of Health to provide advice on the provision of radiation oncology services in NSW.

Members of the Radiotherapy Joint Working Party represent Radiation Oncologists, Radiation Therapists, Medical Physicists, Community and Consumer Representatives and Health Service Planners.

The Radiotherapy Joint Working Party meets quarterly to assist the work of the Cancer Institute and NSW Health in achieving better treatment and outcomes for cancer patients and better and more coordinated cancer care with a particular focus on radiation oncology.

Objectives of the Working Party include the following:

1. Provide advice in regard to the implementation of the current enhancements to radiation oncology services in NSW, to promote improvements in services.
2. Provide advice on strategies to promote the uptake of the principles for provision of radiation oncology services that will lead to improvements in outcomes for cancer patients.
3. Advise on trends in radiotherapy treatments and potential changes in practice and technology which will impact on service delivery.
4. Advise on current variations in practice issues which may need to be addressed.
5. Review the diagnosis and referral patterns of cancer patients to radiation services in NSW and recommend optimal processes for implementation by the Area Health services and private providers.
6. Be aware of the literature, relevant reports and experience of key initiatives in radiation oncology so as to give advice within the context of best practice.
7. Recommend optimal arrangements for integration of radiotherapy departments within a Comprehensive Cancer Care Model, the Clinical Cancer Framework and the NSW Cancer Plan.
8. Recommend methods to develop the disciplines within radiation oncology and in particular how research, teaching and training can be enhanced in NSW.
9. Identify and recommend key criteria that could provide the basis for the future accreditation of radiation oncology services, consistent with ROJIG recommendations.