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• W2891710008 abstract "Whole breast radiotherapy (RT) is a standard management approach in early-stage breast cancer post-lumpectomy. Typically, the multi-step planning process requires wait-times varying from a few days to weeks. At our institution, the Clinical Specialist Radiation Therapist (CSRT) role has arisen as an integral part of an inter-professional team. The breast CSRT functions within the RT on-treatment reviews to assess and manage patient side effects and completes target volume delineation in select early-stage patients. The CSRT role development and validation occurred in parallel to the technological development of automated treatment planning software, which reduces multi-levels of manual planning. The incorporation of new models of care and technological innovation enable the development of a rapid breast RT process. The QuickStart program was developed with the goal to shorten wait-times for whole breast RT. Patients treated through this program have CT simulation, treatment planning and delivery of the first treatment fraction within 24 hours. The streamlined process is led by the advanced practice CSRT, who is responsible for all essential activities required to expedite the planning process, including upfront coordination of CT and treatment times, target delineation, and ongoing communication with the team and patient. The CSRT’s involvement in target delineation for the oncologist’s review and approval allows for increased workload flexibility of the radiation oncologists, enabling them to dedicate time to other complex medical issues and the provision of additional patient care activities. This furthers more efficient and cost-effective models of care. Initial results from a clinical study showed that women treated through QuickStart process received their first treatment 11 days in advance of similar patients treated through the standard process. Departmental quality control checks performed prior to the initiation of RT treatment did not detect any clinical or technical deficiencies in any of the plans. Independent peer-review of each plan in Quality Assurance rounds demonstrated 100% compliance with the departmental protocol. The QuickStart process effectively shortened the wait interval between patient consultation to the initiation of RT treatment and allowed patients to be treated well before the 14-day wait-time standards endorsed by Cancer Care Ontario. Since its inception, the program continues to be expanded to accommodate more patients. To date, more than 340 patients have been treated through this streamlined process. The QuickStart program helps to ensure patients have timely access to high quality care while enabling providers to: collaborate, further best practices, maintain a manageable workload and optimize the use of healthcare resources in a sustainable manner. By aligning the roles within a multidisciplinary team and leveraging technology, patient wait times can be reduced considerably. This innovative model of care offers breast cancer patients the same high quality and effective RT without a delay. Currently, the CSRT is training treatment planners to contour the post-operative cavity to further increase access to this process. Identification of the organizational enablers required for the Breast QuickStart process will enable the development of new models of care within other multi-disciplinary radiation oncology disease sites." @default.
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• W2891710008 date "2018-09-01" @default.
• W2891710008 modified "2023-09-23" @default.
• W2891710008 title "Leading Practice: Implementation of an Innovative Approach to Rapid Breast Radiotherapy" @default.
• W2891710008 doi "https://doi.org/10.1016/j.jmir.2018.06.026" @default.
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