Standardizing Definition of Advanced Practice Radiation Therapy Clinical Activities: Ontario, Canada
PD-0728
Abstract
Standardizing Definition of Advanced Practice Radiation Therapy Clinical Activities: Ontario, Canada
Authors: Kitty Chan1, Kelly Linden2, Biu Chan1, Darby Erler3, Laura D’Almonté4, Vickie Kong1, Julie Kraus5, Nicole Harnett1
1Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Canada; 2The Ottawa Health Science Center, Radiation Therapy, Ottawa, Canada; 3Odette Cancer Centre, Radiation Therapy, Toronto, Canada; 4Windsor Regional Hospital, Radiation Therapy, Windsor, Canada; 5Ontario Health, Radiation Treatment Program, Toronto, Canada
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Purpose or Objective
Clinical Specialist Radiation Therapist (CSRT) is the title assigned to a radiation therapist (RTT) practicing in an advanced capacity with advanced knowledge, skills and judgement in Ontario. A CSRT Community of Practice (CoP) formed a workgroup (WG) to demonstrate impact of CSRTs in their roles.
Material and Methods
In 2017, a consensus building project involving 20 CSRTs and 14 radiation therapy (RT) department managers in Ontario was completed to quantify CSRTs’ clinical impact/workload. In Round 1 & 2, expert feedback was gathered to generate an Advanced Practice (AP) Activity List. In Round 3: 20 CSRTs completed an e-survey to assess applicability of each AP Activity to their role using Likert scale (0-5). A final AP Activity List & Definitions was generated.
Results
Round 1: Forty-seven AP activities were identified to generate the activity list. Round 2: 3/14 RT managers provided 145 feedback statements on Round 1 AP Activity List. The most time consuming part was classifying whether a clinical activity performed by CSRT was considered ‘advanced’. The WG used RT managers’ feedback to clarify AP activities and definitions such as: Patient Education, Contouring Target Volume and combined small AP tasks to a single AP activity, such as New Patient Consultation. These comments were incorporated with the internal AP workload capturing lists from 2 Ontario cancer centres to generate a revised AP Activity List with 20 AP activities. Round 3: 14/20 CSRTs provided Likert scores on this revised list. The most applicable to CSRT were Technical Consultation (4.0), Contouring Target Volume (3.8) and Planning Consultation (3.8); the least applicable was MR Applicator Assessment (0.9).
CODE NAME (Likert score 0-5)
Patient Interactions
01 New Patient Consultation (3.4)
02 Planning Consultation (3.8)
03 Patient Education (3.6)
04 Treatment Completion Consultation (2.7)
05 Follow Up Consultation (2.9)
06 On Treatment Assessment (2.7)
07 Clinical Examinations (2.2)
Multi-disciplinary Consult
08 Pre-treatment Consultation (3.2)
Virtual Consultation
09 Virtual pre-treatment consultation/ assessment (1.7)
10 Virtual Interaction (2.1)
11 Virtual Follow Up Consultation (2.1)
Resource Optimization
12 Triage/Intake (2.4)
13 Care Co-ordination (3.5)
14 Patient Navigation (3.6)
Technical
15 Contouring Target Volumes (3.8)
16 Technical Consultation (4.0)
17 Critical image assessment and approval (3.2)
18 MR Applicator Assessment (0.9)
19 Dose accumulation & adaptive decision (1.7)
20 Request replan or re-scan (2.2)
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Conclusion
This is the first systematic attempt to build consensus on AP clinical activities performed by CSRTs. This list recorded patient-related RT activities; non-clinical CSRT workload such as research, education, innovation, program development were not in the scope of this consensus building project. The Final AP Activity List & Definitions serve as a framework that allows standardized and continuous monitoring of CSRT AP activities.