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Title: Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together

Abstract

Purpose: To review the impact of a workflow enhancement (WE) team in reducing treatment errors that reach patients within radiation oncology. Methods and Materials: It was determined that flaws in our workflow and processes resulted in errors reaching the patient. The process improvement team (PIT) was developed in 2010 to reduce errors and was later modified in 2012 into the current WE team. Workflow issues and solutions were discussed in PIT and WE team meetings. Due to tensions within PIT that resulted in employee dissatisfaction, there was a 6-month hiatus between the end of PIT and initiation of the renamed/redesigned WE team. In addition to the PIT/WE team forms, the department had separate incident forms to document treatment errors reaching the patient. These incident forms are rapidly reviewed and monitored by our departmental and institutional quality and safety groups, reflecting how seriously these forms are treated. The number of these incident forms was compared before and after instituting the WE team. Results: When PIT was disbanded, a number of errors seemed to occur in succession, requiring reinstitution and redesign of this team, rebranded the WE team. Interestingly, the number of incident forms per patient visits did not change when comparing 6 monthsmore » during the PIT, 6 months during the hiatus, and the first 6 months after instituting the WE team (P=.85). However, 6 to 12 months after instituting the WE team, the number of incident forms per patient visits decreased (P=.028). After the WE team, employee satisfaction and commitment to quality increased as demonstrated by Gallup surveys, suggesting a correlation to the WE team. Conclusions: A team focused on addressing workflow and improving processes can reduce the number of errors reaching the patient. Time is necessary before a reduction in errors reaching patients will be seen.« less

Authors:
 [1];  [2]; ; ; ; ;  [1];  [1];  [2]
  1. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)
  2. (United States)
Publication Date:
OSTI Identifier:
22420363
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 89; Journal Issue: 4; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCIDENTS; COMPARATIVE EVALUATIONS; ERRORS; MEDICAL PERSONNEL; MEETINGS; PATIENTS; RADIOTHERAPY; REVIEWS; SAFETY

Citation Formats

Chao, Samuel T., E-mail: chaos@ccf.org, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio, Meier, Tim, Hugebeck, Brian, Reddy, Chandana A., Godley, Andrew, Kolar, Matt, Suh, John H., and Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio. Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together. United States: N. p., 2014. Web. doi:10.1016/J.IJROBP.2014.01.024.
Chao, Samuel T., E-mail: chaos@ccf.org, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio, Meier, Tim, Hugebeck, Brian, Reddy, Chandana A., Godley, Andrew, Kolar, Matt, Suh, John H., & Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio. Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together. United States. doi:10.1016/J.IJROBP.2014.01.024.
Chao, Samuel T., E-mail: chaos@ccf.org, Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio, Meier, Tim, Hugebeck, Brian, Reddy, Chandana A., Godley, Andrew, Kolar, Matt, Suh, John H., and Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio. Tue . "Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together". United States. doi:10.1016/J.IJROBP.2014.01.024.
@article{osti_22420363,
title = {Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together},
author = {Chao, Samuel T., E-mail: chaos@ccf.org and Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio and Meier, Tim and Hugebeck, Brian and Reddy, Chandana A. and Godley, Andrew and Kolar, Matt and Suh, John H. and Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio},
abstractNote = {Purpose: To review the impact of a workflow enhancement (WE) team in reducing treatment errors that reach patients within radiation oncology. Methods and Materials: It was determined that flaws in our workflow and processes resulted in errors reaching the patient. The process improvement team (PIT) was developed in 2010 to reduce errors and was later modified in 2012 into the current WE team. Workflow issues and solutions were discussed in PIT and WE team meetings. Due to tensions within PIT that resulted in employee dissatisfaction, there was a 6-month hiatus between the end of PIT and initiation of the renamed/redesigned WE team. In addition to the PIT/WE team forms, the department had separate incident forms to document treatment errors reaching the patient. These incident forms are rapidly reviewed and monitored by our departmental and institutional quality and safety groups, reflecting how seriously these forms are treated. The number of these incident forms was compared before and after instituting the WE team. Results: When PIT was disbanded, a number of errors seemed to occur in succession, requiring reinstitution and redesign of this team, rebranded the WE team. Interestingly, the number of incident forms per patient visits did not change when comparing 6 months during the PIT, 6 months during the hiatus, and the first 6 months after instituting the WE team (P=.85). However, 6 to 12 months after instituting the WE team, the number of incident forms per patient visits decreased (P=.028). After the WE team, employee satisfaction and commitment to quality increased as demonstrated by Gallup surveys, suggesting a correlation to the WE team. Conclusions: A team focused on addressing workflow and improving processes can reduce the number of errors reaching the patient. Time is necessary before a reduction in errors reaching patients will be seen.},
doi = {10.1016/J.IJROBP.2014.01.024},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 89,
place = {United States},
year = {Tue Jul 15 00:00:00 EDT 2014},
month = {Tue Jul 15 00:00:00 EDT 2014}
}