Radiation therapist‐led weekly patient treatment reviews

Abstract

The purpose of this discussion article is to explore the implementation of radiation therapist‐led treatment reviews as a form of advanced practice for radiation therapists in Australia. The feasibility of such a role, the impact on cancer care services and implementation requirements to enable the position to be implemented effectively in an Australian environment are explored. Current practice involving weekly patient treatment reviews and cases where health professionals other than radiation oncologists have undertaken this role will be evaluated. Recommendations on its implementation in an Australian environment are also given. An extensive literature review was conducted through the databases ScienceDirect, Medline and CINAHL. Searches were carried out using the following keywords; “radi*” and “prescribing”, “radi*” and “patient review” and “radi*” and “role development”. Abstracts of the yielded results were appraised and those that matched criteria for analysis underwent critical review for inclusion in the discussion. Although steps have been taken to implement the advanced practice role of a treatment review radiation therapist in Australia, little has been done to formalise the role. It is evident from the international literature that the radiation therapist‐led reviewer role has resulted in benefits to patients, medical specialists and therapists. This advanced practice role has the potential to increase radiation therapist retention and recruitment. Implementation of this role in the Australian environment would be advantageous; however criteria outlining the scope of practice and remuneration packages need to be established to facilitate the synthesis of this role in a clinical environment.

Advanced practice radiation therapists: an Australian context

“…Despite interest shown in an AP model, a review published in 2009 identified a lack of data in Australia identifying or evaluating APRT roles with a further study noting little progress had been made towards formal APRT roles. Further to this, in 2009, Dempsey and Burr noted that radiation therapists were “reluctant to progress the issue of responsibility for higher level plans and treatment…..without the appointment at a senior or advanced practitioner level” .…”

An exploration of the feasibility of radiation therapist participation in treatment reviews

“…With much initial work done in the United Kingdom, RT participation in review clinics has been in practice since at least 2000 in some parts of the world in the context of the development of advanced practice models. Reported benefits include increased communication, decreased patient waiting times, and more consistent patient monitoring and management . RO time and workload is saved and can be utilized to assess more complex patients or to perform other higher level duties.…”

“…The increased role for RTs has potential advantages of improved job satisfaction and better recruitment and retention . Data have shown that some patients present to clinics with minimal treatment‐related sequelae, resulting in a low medical intervention (MI) rate occurring in clinics . This low need for MI further enables RT participation …”

“…Patients have indicated they are receptive towards RT reviews . In one study of 865 breast cancer patients, 97.6% were happy to not see their RO during treatment and 99.7% were highly satisfied with time spent with the RT review staff .…”

“…Internationally, strong evidence exists to support RT participation in review clinics . While information is available regarding the scope of practice and capabilities of RTs in performing reviews in the United Kingdom, there is still much variation in implementation between centres, largely due to differences in local need.…”