The Clinical Specialist Radiation Therapist (CSRT): A case study exploring the effectiveness of a new advanced practice role in Canada

Abstract

IntroductionThe Clinical Specialist Radiation Therapist (CSRT), is a new advanced practice (AP) role for radiation therapists (RTTs). Following training, education and evaluation, the CSRT performs specific duties in autonomous ways, making advanced clinical decisions in their area of specialization. This case study examines the CSRT's impact on quantity (i.e., increasing capacity), improving quality and stimulating research and innovation.MethodsBetween 2007 and 2016, 23 CSRTs worked in 10 cancer centres in various AP position. A standardised metrics package, focusing on wait‐times, patient volumes, patient throughput, time‐savings, quality initiatives, satisfaction, research and innovation was developed and used to collect qualitative and quantitative data. Data were self‐reported by the CSRTs but electronic databases, pre/post‐studies, surveys and interviews were also used.ResultsQuantity projects (n = 76) related to patient volumes, wait‐times, patient throughput and time‐savings increased capacity and allowed more patients to enter the system. The presence of a CSRT allowed, on average, 13 additional patients (either new or re‐treated) to be seen, at their respective cancer centre, per month. An average of 1.4 yearly quality improvement initiatives were led by each CSRT, which contributed to improvements in quality of care and satisfaction. CSRTs demonstrated a high level of involvement in research, innovation and knowledge translation activities, either as leaders or part of interprofessional teams.ConclusionCSRTs positively impact quantity (capacity of the system), quality, research and innovation. Future efforts include permanent and sustainable team integration, practice standards, formal and comprehensive educational preparation, and approaches to consistent, valid assessment of AP in radiation therapy.

The sustainability of the New Zealand radiation therapy workforce: Factors that influence intent to leave the workplace and profession

“…The need for a formalized framework for RTs to expand their practice is well documented [9][10][11][12]; despite this need, there seems to have been little done implementing this in Australia and New Zealand. In Ontario, Canada an advanced practice Clinical Specialist Radiation Therapist (CSRT) role and practice framework has been successfully implemented [12,13]. This has relieved local workforce pressures while allowing RTs to work at the full scope of their practice [9,12].…”

“…Several factors such as limited opportunities for professional development, working conditions and issues with management have been identified in the literature to influence a RTs intent to leave the profession [8]. The issue of RT career advancement has been well documented [9][10][11][12][13]. Halkett et al [14] found that RTs perceived that there were limited opportunities to specialise and that any further education had little chance of being recognised.…”

Étude rétrospective sur l’intensification des pratiques de radiothérapie hypofractionnée : le virage organisationnel

“…À moyen terme, il est pertinent d’envisager une nouvelle fonction de manipulateur en pratique avancée en radiothérapie (CSRT pour clinical specialist radiation therapist ) afin de faire face aux changements induits par la radiothérapie hypofractionnée. L’apport de cette nouvelle fonction a été évalué au Canada de 2007 à 2016 dans dix centres de radiothérapie [35] . Elle permet d’améliorer la qualité des soins dispensés aux patients et de faciliter les progrès de la science et de la pratique de la radiothérapie, tout en augmentant la capacité de prise en charge de patient, l’efficience des différentes étapes du workflow et la satisfaction des patients, des manipulateurs et de l’encadrement.…”

Rapid Access Palliative Radiotherapy Programmes

“…Motivated individuals have developed clinical, technical and professional competencies relevant to the operations of their programmes and brought about meaningful change by working more autonomously within them. By performing duties traditionally carried out by radiation oncologists and initiating programmatic changes, wait times have decreased, and patient throughput and system capacities have improved [42].…”