The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic

Fairchild, Alysa; Pituskin, Edith; Rose, Brenda; Ghosh, Sunita; Dutka, Jennifer; Driga, Amy; Tachynski, P.; Borschneck, J.; Gagnon, Lori; MacDonnell, S.; Middleton, Jacqueline; Thavone, Kitta; Carstairs, Sharon; Brent, D Kaziny; Severin, Diane

doi:10.1007/s00520-008-0468-3

Cited by 67 publications

(101 citation statements)

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“…While clinical studies examine a clearly defined problem relating to a limited subgroup, health services research describes patient care and its framework conditions and evaluates them under everyday conditions (pattern-of-care studies, [20]). The Canadian Rapid Response Radiotherapy Program was evaluated using a pattern-of-care study [2,11]. This approach has also proven to be effective in the German Hospice and Palliative Care Evaluation (HOPE, [25]).…”

Section: Introductionmentioning

confidence: 99%

Patterns of Care and Course of Symptoms in Palliative Radiotherapy

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Patterns of Care and Course of Symptoms in Palliative Radiotherapy

et al. 2011

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“…7 Similarly, during the pilot of the Rapid Access Palliative Radio-therapy Program (RAPRP) in Edmonton, 89% of patients were prescribed a single fraction of RT for their painful bone metastasis, with treatment completion within the same day as their assessment. 6 These care delivery models facilitate urgent RT and provide multidisciplinary care that addresses these patients' frequent somatic symptoms and psychosocial needs. 11 The success of these models is evidenced by not only the high proportion of patients who initiate (RRRP) 7 or complete treatment within the same day of their evaluation (RAPRP), 6 but also by the large proportion of satisfied patients and referring physicians.…”

Section: Discussionmentioning

confidence: 99%

“…6 These care delivery models facilitate urgent RT and provide multidisciplinary care that addresses these patients' frequent somatic symptoms and psychosocial needs. 11 The success of these models is evidenced by not only the high proportion of patients who initiate (RRRP) 7 or complete treatment within the same day of their evaluation (RAPRP), 6 but also by the large proportion of satisfied patients and referring physicians. 8 To our knowledge there are no available data on how palliative radiation oncology care is delivered within the US, but indirect findings suggest that palliative radiation oncology practices require quality improvement.…”

Section: Discussionmentioning

confidence: 99%

“…In light of the unique clinical needs of advanced cancer patients, dedicated clinical services may also benefit PCC within radiation oncology. Among the few institutions with dedicated services, 6,7 limited data suggest that they help enable their department to meet the clinical care needs of palliative cancer patients. 8 Given the large number of palliative cancer patients seen for RT and the American Society of Clinical Oncology's (ASCO) 2011 statement calling for improvement of palliative cancer care, 5 further data are required to describe how dedicated palliative radiation oncology services impact the quality of palliative cancer care.…”

Section: Introductionmentioning

confidence: 99%

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The Supportive and Palliative Radiation Oncology Service: The Impact of a Dedicated Service on Palliative Cancer Care

Krishnan¹,

Tseng²,

Sullivan

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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Purpose-The American Society of Clinical Oncology has recommended tailoring palliative cancer care (PCC) to the distinct and complex needs of advanced cancer patients. The Supportive and Palliative Radiation Oncology (SPRO) service was initiated July 2011 to provide dedicated palliative radiation oncology (RO) care to cancer patients. We used care providers' ratings to assess SPRO's impact on the quality of PCC and compared perceptions of PCC delivery among physicians practicing with and without a dedicated palliative RO service.Methods and materials-An online survey was sent to 117 RO care providers working at 4 Boston-area academic centers. Physicians and nurses at the SPRO-affiliated center rated the impact of the SPRO service on 8 PCC quality measures (7-point scale, "very unfavorably" to "very favorably"). Physicians at all sites rated their department's performance on 10 measures of PCC (7-point scale, "very poorly" to "very well").Results-Among 102 RO care providers who responded (response rate, 89% for physicians; 83% for nurses), large majorities believed that SPRO improved the following PCC quality measures: overall quality of care (physician/nurse, 98%/92%); communication with patients and families (95%/96%); staff experience (93%/84%); time spent on technical aspects of PCC (eg, reviewing imaging) (88%/56%); appropriateness of treatment recommendations (85%/84%); appropriateness of dose/fractionation (78%/60%); and patient follow-up (64%/68%). Compared with physicians practicing in departments without a dedicated palliative RO service, physicians at Conflicts of interest: None HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript the SPRO-affiliated department rated the overall quality of their department's PCC more highly (P = .02).Conclusions-Clinicians indicated that SPRO improved the quality of PCC. Physicians practicing within this dedicated service rated their department's overall PCC quality higher than physicians practicing at academic centers without a dedicated service. These findings point to dedicated palliative RO services as a promising means of improving PCC quality.

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“…Multidisciplinary RRPC have shown to expedite patient's palliative radiotherapy both nationally and internationally 2, 9, 10. An assessment of the established RRPC at ROMC in 2005, showed patients referred to the RRPC waited less time to receive palliative radiotherapy compared with patients seen outside the RRPC 2.…”

Section: Introductionmentioning

confidence: 99%

Reducing radiotherapy waiting times for palliative patients: The role of the Advanced Practice Radiation Therapist

Job

Holt

Bernard

2017

J of Medical Radiation Sci

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IntroductionPalliative radiotherapy is effective in reducing symptom burden and improving quality of life in patients with symptomatic metastatic cancer and should be delivered in a timely manner. The aim of this study was to determine whether referring patients directly to a Palliative Advanced Practice Radiation Therapist (APRT) improves access to palliative radiotherapy and reduces time from referral to treatment.MethodsAt Radiation Oncology Mater Center (ROMC) in Brisbane, Australia a new referral pathway was developed which involved patients requiring palliative radiotherapy, being referred directly to the APRT from a single external hospital medical oncology and palliative care departments. Over a 5 months period, patient demographics and time in working days from referral to treatment were compared for consecutive palliative patients seen within our department. Patients were stratified by method of referral i.e. via the new referral pathway (NP) or via standard referral pathway (SP).ResultsBetween October 2014 and March 2015, a total of 150 patients were referred for palliative radiotherapy. Of these patients, 48 were referred and processed via the NP. There was a significant reduction in the number of days from referral to treatment for patients referred through the NP. Patients referred through the NP via the APRT had a mean and median wait time of 3.5 and 3 days respectively compared with 8.1 and 5 days for patients referred through the SP (P = <0.001). Patients were also more likely to have the treatment completed with less visits to the hospital (P < 0.001).ConclusionsThe new referral pathway utilising a dedicated palliative APRT decreased waiting times for patients receiving palliative radiotherapy and improved timely access to the radiotherapy service for both referrers and patients.

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The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic

Abstract: Early needs assessment was advantageous in determining the optimal team and methods of assessment for our 'one-stop' BM clinic. This approach was successful in improving pain and other symptoms, and the convenience of seeing multiple providers on 1 day was appreciated by the patients.

Cited by 67 publications

References 18 publications

Patterns of Care and Course of Symptoms in Palliative Radiotherapy

Patterns of Care and Course of Symptoms in Palliative Radiotherapy

The Supportive and Palliative Radiation Oncology Service: The Impact of a Dedicated Service on Palliative Cancer Care

Reducing radiotherapy waiting times for palliative patients: The role of the Advanced Practice Radiation Therapist

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