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. 2023 Mar 15;8(4):101218.
doi: 10.1016/j.adro.2023.101218. eCollection 2023 Jul-Aug.

Improving Communication of Peer-Review Conference Outcomes: A Practical Experience

Joseph A Jones  1 , Michael H Soike  2 , D Hunter Boggs  2 , John B Fiveash  2 , Rex A Cardan  2 , James A Bonner  2 , Andrew M McDonald  2
Affiliations

Improving Communication of Peer-Review Conference Outcomes: A Practical Experience

Joseph A Jones et al. Adv Radiat Oncol. .

Abstract

Purpose: The aim of this work was to describe the design and implementation of a more robust workflow for communicating outcomes from a peer-review chart rounds conference. We also provide information regarding cycle times, plan revisions, and other key metrics that we have observed since initial implementation.

Methods and materials: A multidisciplinary team of stakeholders including physicians, physicists, and dosimetrists developed a revised peer-review workflow that addressed key needs to improve the prior process. Consensus terminology was developed to reduce ambiguity regarding the priority of peer-review outcomes and to clarify expectations of the treating physician in response to peer-review outcomes. A custom workflow software tool was developed to facilitate both upstream and downstream processes from the chart rounds conference. The peer-review outcomes of the chart rounds conference and resulting plan changes for the first 18 months of implementation were summarized.

Results: In the first 18 months after implementation of the revised processes, 2294 plans were reviewed, and feedback priority levels assigned. Across all cases with feedback, the median time for the treating attending physician to acknowledge conference comments was 1 day and was within 7 calendar days for 89.1% of cases. Conference feedback was acknowledged within 1 day for 74 of 115 (64.3%) cases with level 2 comments and for 18 of 21 (85.7%) cases with level 3 comments (P = .054). Contours were modified in 13 of 116 (11%) cases receiving level 2 feedback and 10 of 21 (48%) cases receiving level 3 feedback (P < .001). The treatment plan was revised in 18 of 116 (16%) cases receiving level 2 feedback and 13 of 21 (61%) cases receiving level 3 feedback (P < .001).

Conclusions: We successfully implemented a workflow to improve upstream and downstream processes for a chart rounds conference. Standardizing how peer-review outcomes were communicated and recording physician responses allow for improved ability to monitor conference activities.

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Figures

Figure 1
Figure 1
Framework of peer-review workflow before 2020 (upper) and revised workflow (lower).
Figure 2
Figure 2
Screenshot of ProcessMaker electronic peer-review comments worksheet (top panel) and physician acknowledgment form (bottom panel).
Figure 3
Figure 3
Scatter plot of days to acknowledgment of peer-review comments plotted over time since program implementation.
See this image and copyright information in PMC

References

    1. Cui T, Ward MC, Joshi NP, et al. Correlation between plan quality improvements and reduced acute dysphagia and xerostomia in the definitive treatment of oropharyngeal squamous cell carcinoma. Head Neck. 2019;41:1096–1103. - PubMed
    1. Giraud P, Racadot S, Vernerey D, et al. Investigation of relation of radiation therapy quality with toxicity and survival in LAP07 phase 3 trial for locally advanced pancreatic carcinoma. Int J Radiat Oncol Biol Phys. 2021;110:993–1002. - PubMed
    1. Boustani J, Rivin Del Campo E, Blanc J, et al. Quality assurance of dose-escalated radiation therapy in a randomized trial for locally advanced oesophageal cancer. Int J Radiat Oncol Biol Phys. 2019;105:329–337. - PubMed
    1. Kearvell R, Haworth A, Ebert MA, et al. Quality improvements in prostate radiotherapy: outcomes and impact of comprehensive quality assurance during the TROG 03.04 'RADAR' trial. J Med Imaging Radiat Oncol. 2013;57:247–257. - PubMed
    1. Tol JP, Dahele M, Gregoire V, Overgaard J, Slotman BJ, Verbakel W. Analysis of EORTC-1219-DAHANCA-29 trial plans demonstrates the potential of knowledge-based planning to provide patient-specific treatment plan quality assurance. Radiother Oncol. 2019;130:75–81. - PubMed

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