Radiation treatment (RT) planning is when a team of radiation oncologists, radiation therapists, and medical physicists determines the appropriate external beam RT or brachytherapy treatment approach for a patient with cancer.

Peer review of radiation treatment plans is the key to improve the quality of radiation treatment. The question was, “What is the impact of the Cancer Care Ontario (CCO) strategy to accelerate the use of peer-review processes in radiation oncology across all of its 14 cancer treatment centers?” 

For the study, Ontario’s 14 regional cancer centres range in size from two to 18 treatment units (103 units in total) that deliver from 870 to more than 10,500 RT courses annually at both academic and community hospitals. 

Following several key change management principles for organizational transformation, the peer-review increased from 43.5% (April 2013) to 68.0% (March 2015), with some centres reaching over 95%. The performance target was set at 50% and revised at 60% in 2014, which was overpassed at 58.2% and 68.2% in both years, respectively.

In years one (2013 to 2014) and two (2014 to 2015) of the initiative, respectively, however, 15.2% and 15.6% of plans peer-reviewed in Ontario cancer centres were peer-reviewed after 25% of treatment visits were completed. A change management framework can help plan and achieve substantial increases in peer-review activities on a jurisdictional basis.

One could extend peer-review principles to other oncological disciplines to improve individual patient care and overall program quality.

Ref: https://ascopubs.org/doi/full/10.1200/JOP.2015.006882 

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