1
|
Krzeszowiak J, Pach R, Richter P, Lorenc Z, Rutkowski A, Ochwat K, Zegarski W, Frączek M, Szczepanik A. The impact of oncological package implementation on the treatment of rectal cancer in years 2013-2019 in Poland - multicenter study. POLISH JOURNAL OF SURGERY 2024; 96:18-25. [PMID: 38940243 DOI: 10.5604/01.3001.0054.2680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
<b><br>Introduction:</b> In 2015, in Poland, the oncological package (OP) was established. This law constituted a fast track of oncological diagnosis and treatment and obligatory multidisciplinary team meetings (MDT).</br> <b><br>Aim:</b> The aim of this study was to analyze the impact of OP on rectal cancer treatment.</br> <b><br>Methods:</b> The study was a multicenter, retrospective analysis of data collected from five centers. It included clinical data of patients operated on due to rectal cancer between 2013 and 2019. For most analyses, patients were categorized into three groups: 2013-2014 - before OP (A), 2015-2016 - early development of OP (B), 2017-2019 - further OP functioning (C).</br> <b><br>Results:</b> A total of 1418 patients were included. In all time intervals, the majority of operations performed were anterior resections. There was a significantly lower local tumor stage (T) observed in subsequent time intervals, while there were no significant differences for N and M. In period C, the median of resected nodes was significantly higher than in previous periods. Four of the centers showed an increasing tendency in the use of preoperative radiotherapy. The study indicated a significant increase in the use of short-course radiotherapy (SCRT) and a decrease in the number of patients who did not receive any form of preoperative therapy in subsequent periods. In the group that should receive radiotherapy (T3/4 or N+ and M0), the use of SCRT was also significantly increasing.</br> <b><br>Conclusions:</b> In the whole cohort, there was a significant increase in the use of preoperative radiotherapy and a decrease in the T stage, changing with the development of OP. Nevertheless, this relation is indirect and more data should be gathered for further conclusions.</br>.
Collapse
Affiliation(s)
| | - Radosław Pach
- 1st Department of Surgery, Jagiellonian University, Krakow, Poland
| | - Piotr Richter
- 1st Department of Surgery, Jagiellonian University, Krakow, Poland
| | - Zbigniew Lorenc
- Department of General, Colorectal and Multiple-Organ Surgery, Medical University of Silesia in Katowice, Poland
| | - Andrzej Rutkowski
- Department of Gastroenterological Oncology, M. Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Wojciech Zegarski
- Department of Surgical Oncology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
| | - Mariusz Frączek
- Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Poland
| | | |
Collapse
|
2
|
Jornet N, Strojan P, Howlett DC, Brady AP, Hierath M, Clark J, Wadsak W, Giammarile F, Coffey M. The QuADRANT study: Current status and recommendations for improving uptake and implementation of clinical audit of medical radiological procedures in Europe. The radiotherapy perspective. Radiother Oncol 2023; 186:109772. [PMID: 37385381 DOI: 10.1016/j.radonc.2023.109772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND QuADRANT was a research project funded by the European Commission to evaluate clinical audit uptake and implementation across Europe, with an emphasis on clinical audit as mandated within the BSSD (Basic Safety Standards Directive). AIM Focusing on the QuADRANT objectives - to obtain an overview of European clinical audit activity; identify good practices, resources, barriers and challenges; provide guidance and recommendations going forwards; identify the potential for European Union action on quality and safety focusing on the field of radiotherapy. RESULTS A pan-European survey, expert interviews and a literature review conducted within the framework of the QuADRANT project indicated that developments in national clinical audit infrastructure are required. While in radiotherapy, there is a strong tradition and high level of experience of dosimetry audits and well-established practice through the IAEA's QUATRO audits, few countries have a well-established comprehensive clinical audit programme or international/national initiatives on tumour specific clinical audits. Even if sparse, the experience from countries with established system of quality audits can be used as role-models for national professional societies to promote clinical audit implementation. However, resource allocation and national prioritisation of clinical audit are needed in many countries. National and international societies should take the initiative to promote and facilitate training and resources (guidelines, experts, courses) for clinical audits. Enablers used to enhance clinical audit participation are not widely employed. Development of hospital accreditation programmes can facilitate clinical audit uptake. An active and formalised role for patients in clinical audit practice and policy development is recommended. Because there is a persisting variation in European awareness of BSSD clinical audit requirements, work is needed to improve dissemination of information on the legislative requirements relating to clinical audit in the BSSD and in relation to inspection processes. The aim is to ensure these include clinical audit and that they encompass all clinics and specialties involved in medical applications using ionising radiation. CONCLUSION QuADRANT provided an overarching view of clinical audit practice in Europe, with all its related aspects. Unfortunately, it showed that the awareness of the BSSD requirements for clinical audit are highly variable. Therefore, there is an urgent need to dedicate efforts towards ensuring that regulatory inspections also incorporate an assessment of clinical audit program(s), affecting all aspects of clinical work and specialties involved in patient exposure to ionising radiation.
Collapse
Affiliation(s)
- Núria Jornet
- Servei de Radiofísica i Radioprotecció, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; European Society for Radiotherapy and Oncology, Brussels, Belgium.
| | - Primoz Strojan
- Dept. of Radiation Oncology, Institute of Oncology Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia; European Society for Radiotherapy and Oncology, Brussels, Belgium
| | - David C Howlett
- Radiology Department, East Sussex Healthcare NHS Trust, Brighton and Sussex Medical School, UK; European Society of Radiology (ESR), Vienna, Austria
| | - Adrian P Brady
- Radiology Department, Mercy University Hospital, Cork, Ireland; Radiology Department, University College Cork, Ireland; European Society of Radiology (ESR), Vienna, Austria
| | | | | | - Wolfgang Wadsak
- European Association of Nuclear Medicine, Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Francesco Giammarile
- European Association of Nuclear Medicine, Vienna, Austria; Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna, Austria
| | - Mary Coffey
- Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland; European Society for Radiotherapy and Oncology, Brussels, Belgium
| |
Collapse
|
3
|
Malicki J, Castro CL, Fundowicz M, Krengli M, Llacer-Moscardo C, Curcean S, Montplet CM, Carvalho L, Konstanty E, Barragan TH, Pisani C, Laszlo I, Garau MM, Kruszyna-Mochalska M, Lencart J, Zwierzchowska D, Serrano AR, Brezae A, Varela EL, Milecki P, Zannetti M, Coza O, Gonzalez E, Beldì D, Guedea F. IROCA-TES: Improving Quality in Radiation Oncology through Clinical Audits - Training and Education for Standardization. Rep Pract Oncol Radiother 2023; 28:429-432. [PMID: 37795403 PMCID: PMC10547405 DOI: 10.5603/rpor.a2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/23/2023] [Indexed: 10/06/2023] Open
Abstract
Background Clinical audits are an important tool to objectively assess clinical protocols, procedures, and processes and to detect deviations from good clinical practice. The main aim of this project is to determine adherence to a core set of consensus- based quality indicators and then to compare the institutions in order to identify best practices. Materials and methods We conduct a multicentre, international clinical audit of six comprehensive cancer centres in Poland, Spain, Italy, Portugal, France, and Romania as a part of the project, known as IROCATES (Improving Quality in Radiation Oncology through Clinical Audits - Training and Education for Standardization). Results Radiotherapy practice varies from country to country, in part due to historical, economic, linguistic, and cultural differences. The institutions developed their own processes to suit their existing clinical practice. Conclusions We believe that this study will contribute to establishing the value of routinely performing multi-institutional clinical audits and will lead to improvement of radiotherapy practice at the participating centres.
Collapse
Affiliation(s)
- Julian Malicki
- Electroradiology Department, University of Medical Sciences, Poznan, Poland
- Greater Poland Cancer Centre, Poznan, Poland
| | - Carla Lopes Castro
- Department of Radiotherapy, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal
| | | | - Marco Krengli
- Department of Radiation Oncology, University Hospital “Maggiore della Carità”, Novara, Italy
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Sebastian Curcean
- Department of Radiation Oncology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | - Carles Muñoz Montplet
- Department of Medical Physics and Radiation Protection, Catalan Institute of Oncology, Girona, Spain
| | - Luisa Carvalho
- Department of Radiotherapy, Instituto Português de Oncologia do Porto Francisco Gentil, Portugal
| | - Ewelina Konstanty
- Medical Physics Department, The Greater Poland Cancer Centre, Poznan, Poland
| | - Tania Hernandez Barragan
- Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, Mexico
| | - Carla Pisani
- Department of Radiation Oncology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Istvan Laszlo
- Department of Radiation Oncology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | - Miquel Macià Garau
- Department of Radiation Oncology, Catalan Institute of Oncology, Barcelona, Spain
| | - Marta Kruszyna-Mochalska
- Electroradiology Department, University of Medical Sciences, Poznan, Poland
- Medical Physics Department, The Greater Poland Cancer Centre, Poznan, Poland
| | - Joana Lencart
- Medical Physics Service & Medical Physics, Radiobiology and Radiation Protection Group CI-IPOP, Instituto Português de Oncologia do Porto
| | | | | | | | - Eva Loureiro Varela
- Department of Information Systems, Catalan Institute of Oncology, (ICO) Barcelona, Spain
| | - Piotr Milecki
- Electroradiology Department, University of Medical Sciences, Poznan, Poland
- Radiotherapy Ward I, Greater Poland Cancer Centre, Poznan, Poland
| | - Micol Zannetti
- Department of Radiation Oncology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Ovidiu Coza
- Department of Radiotherapy with High Energies and Brachytherapy, Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
| | - Eva Gonzalez
- Department of Processes & Quality Management, Catalan Institute of Oncology, Barcelona, Spain
| | - Debora Beldì
- Department of Radiation Oncology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Ferran Guedea
- Department of Radiation Oncology, Catalan Institute of Oncology, Barcelona, Spain
| |
Collapse
|
4
|
Lopes de Castro C, Fundowicz M, Roselló A, Jové J, Deantonio L, Aguiar A, Pisani C, Villà S, Boladeras A, Konstanty E, Kruszyna-Mochalska M, Milecki P, Jurado-Bruggeman D, Lencart J, Modolell I, Muñoz-Montplet C, Aliste L, Torras MG, Puigdemont M, Carvalho L, Krengli M, Guedea F, Malicki J. Results of the IROCA international clinical audit in prostate cancer radiotherapy at six comprehensive cancer centres. Sci Rep 2021; 11:12323. [PMID: 34112863 PMCID: PMC8192927 DOI: 10.1038/s41598-021-91723-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/21/2021] [Indexed: 11/24/2022] Open
Abstract
To assess adherence to standard clinical practice for the diagnosis and treatment of patients undergoing prostate cancer (PCa) radiotherapy in four European countries using clinical audits as part of the international IROCA project. Multi-institutional, retrospective cohort study of 240 randomly-selected patients treated for PCa (n = 40/centre) in the year 2015 at six European hospitals. Clinical indicators applicable to general and PCa-specific radiotherapy processes were evaluated. All data were obtained directly from medical records. The audits were performed in the year 2017. Adherence to clinical protocols and practices was satisfactory, but with substantial inter-centre variability in numerous variables, as follows: staging MRI (range 27.5-87.5% of cases); presentation to multidisciplinary tumour board (2.5-100%); time elapsed between initial visit to the radiation oncology department and treatment initiation (42-102.5 days); number of treatment interruptions ≥ 1 day (7.5-97.5%). The most common deviation from standard clinical practice was inconsistent data registration, mainly failure to report data related to diagnosis, treatment, and/or adverse events. This clinical audit detected substantial inter-centre variability in adherence to standard clinical practice, most notably inconsistent record keeping. These findings confirm the value of performing clinical audits to detect deviations from standard clinical practices and procedures.
Collapse
Affiliation(s)
- Carla Lopes de Castro
- Instituto Português de Oncologia, Porto, Portugal.
- Department of Radiation Oncology, Instituto Português de Oncologia Francisco Gentil-Porto, Porto, Portugal.
| | | | | | - Josep Jové
- Institut Català d'Oncologia, Badalona, Spain
| | - Letizia Deantonio
- Università degli Studi del Piemonte Orientale (UNIUPO), Novara, Italy
| | - Artur Aguiar
- Instituto Português de Oncologia, Porto, Portugal
| | - Carla Pisani
- Università degli Studi del Piemonte Orientale (UNIUPO), Novara, Italy
| | | | - Anna Boladeras
- Institut Català d'Oncologia, L'Hospitalet, Barcelona, Spain
| | | | - Marta Kruszyna-Mochalska
- Department of Electroradiology, Poznan University of Medical Sciences, Poznan, Poland
- Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Milecki
- Department of Electroradiology, Poznan University of Medical Sciences, Poznan, Poland
- Greater Poland Cancer Centre, Poznan, Poland
| | | | | | | | | | - Luisa Aliste
- Institut Català d'Oncologia, L'Hospitalet, Barcelona, Spain
| | | | | | | | - Marco Krengli
- Università degli Studi del Piemonte Orientale (UNIUPO), Novara, Italy
| | - Ferran Guedea
- Institut Català d'Oncologia, L'Hospitalet, Barcelona, Spain
| | - Julian Malicki
- Department of Electroradiology, Poznan University of Medical Sciences, Poznan, Poland
- Greater Poland Cancer Centre, Poznan, Poland
| |
Collapse
|
5
|
Fundowicz M, Aguiar A, de Castro CL, Torras MG, Deantonio L, Konstanty E, Kruszyna-Mochalska M, Macia M, Canals E, Caro M, Pisani C, Zwierzchowska D, Molero J, Eraso A, Lencart J, Muñoz-Montplet C, Carvalho L, Krengli M, Malicki J, Guedea F. Multicentre clinical radiotherapy audit in rectal cancer: results of the IROCA project. Radiat Oncol 2020; 15:208. [PMID: 32854730 PMCID: PMC7453535 DOI: 10.1186/s13014-020-01648-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/19/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To perform a clinical audit to assess adherence to standard clinical practice for the diagnosis, treatment, and follow-up of patients undergoing radiotherapy for rectal cancer treatment in four European countries. MATERIALS AND METHODS Multi-institutional, retrospective cohort study of 221 patients treated for rectal cancer in 2015 at six European cancer centres. Clinical indicators applicable to general radiotherapy processes were evaluated. All data were obtained from electronic medical records. RESULTS The audits were performed in the year 2017. We found substantial inter-centre variability in adherence to standard clinical practices: 1) presentation of cases at departmental clinical sessions (range, 0-100%) or multidisciplinary tumour board (50-95%); 2) pretreatment MRI (61.5-100%) and thoracoabdominal CT (15.0-100%). Large inter-centre differences were observed in the mean interval between biopsy and first visit to the radiotherapy department (range, 21.6-58.6 days) and between the first visit and start of treatment (15.1-38.8 days). Treatment interruptions ≥ 1 day occurred in 43.9% (2.5-90%) of cases overall. Treatment compensation was performed in 2.1% of cases. Treatment was completed in the prescribed time in 55.7% of cases. CONCLUSIONS This multi-institutional clinical audit revealed that most centres adhered to standard clinical practices for most of the radiotherapy processes-related variables assessed. However, the audit revealed marked inter-centre variability for certain quality indicators, particularly inconsistent record keeping. Multiple targets for improvement and/or harmonisation were identified, confirming the value of routine clinical audits to detect potential deviations from standard clinical practice.
Collapse
Affiliation(s)
| | - Artur Aguiar
- Instituto Português de Oncologia; do Porto FG, EPE (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Carla Lopes de Castro
- Instituto Português de Oncologia; do Porto FG, EPE (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Maria Glòria Torras
- Institut Català d’Oncologia, L’Hospitalet, Avinguda Granvia de l’Hospitalet, 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Letizia Deantonio
- “Amedeo Avogadro” - Rettorato, Università degli Studi del Piemonte Orientale (UNIUPO), via Duomo, 6 - 13100 Vercelli, Novara, Italy
| | | | - Marta Kruszyna-Mochalska
- Greater Poland Cancer Centre, Garbary 15 St, 61-866 Poznan, Poland
- Deparment of Electroradiology, University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland
| | - Miquel Macia
- Institut Català d’Oncologia, L’Hospitalet, Avinguda Granvia de l’Hospitalet, 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Eugeni Canals
- Institut Català d’Oncologia, Avinguda de França, S/N 17007, Girona, Spain
| | - Monica Caro
- Institut Català d’Oncologia, Ctra. Canyet s/n 08916, Badalona, Spain
| | - Carla Pisani
- “Amedeo Avogadro” - Rettorato, Università degli Studi del Piemonte Orientale (UNIUPO), via Duomo, 6 - 13100 Vercelli, Novara, Italy
| | | | - Jaume Molero
- Institut Català d’Oncologia, Ctra. Canyet s/n 08916, Badalona, Spain
| | - Arantxa Eraso
- Institut Català d’Oncologia, L’Hospitalet, Avinguda Granvia de l’Hospitalet, 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Joana Lencart
- Instituto Português de Oncologia; do Porto FG, EPE (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Carles Muñoz-Montplet
- Institut Català d’Oncologia, L’Hospitalet, Avinguda Granvia de l’Hospitalet, 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Luisa Carvalho
- Instituto Português de Oncologia; do Porto FG, EPE (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Marco Krengli
- “Amedeo Avogadro” - Rettorato, Università degli Studi del Piemonte Orientale (UNIUPO), via Duomo, 6 - 13100 Vercelli, Novara, Italy
| | - Julian Malicki
- Greater Poland Cancer Centre, Garbary 15 St, 61-866 Poznan, Poland
- Deparment of Electroradiology, University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland
| | - Ferran Guedea
- Institut Català d’Oncologia, L’Hospitalet, Avinguda Granvia de l’Hospitalet, 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
6
|
Torras MG, Canals E, Muñoz-Montplet C, Vidal A, Jurado D, Eraso A, Villà S, Caro M, Molero J, Macià M, Puigdemont M, González-Muñoz E, López A, Guedea F, Borras JM. Improving quality of care and clinical outcomes for rectal cancer through clinical audits in a multicentre cancer care organisation. Radiat Oncol 2020; 15:28. [PMID: 32005123 PMCID: PMC6995177 DOI: 10.1186/s13014-020-1465-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/14/2020] [Indexed: 01/25/2023] Open
Abstract
Introduction Colorectal cancer treatment requires a complex, multidisciplinary approach. Because of the potential variability, monitoring through clinical audits is advisable. This study assesses the effects of a quality improvement action plan in patients with locally advanced rectal cancer and treated with radiotherapy. Methods Comparative, multicentre study in two cohorts of 120 patients each, selected randomly from patients diagnosed with rectal cancer who had initiated radiotherapy with a curative intent. Based on the results from a baseline clinical audit in 2013, a quality improvement action plan was designed and implemented; a second audit in 2017 evaluated its impact. Results Standardised information was present on 77.5% of the magnetic resonance imaging (MRI) staging reports. Treatment strategies were similar in all three study centres. Of the patients whose treatment was interrupted, just 9.7% received a compensation dose. There was an increase in MRI re-staging from 32.5 to 61.5%, and a significant decrease in unreported circumferential resection margins following neoadjuvant therapy (ypCRM), from 34.5 to 5.6% (p < 0.001). Conclusions The comparison between two clinical audits showed improvements in neoadjuvant radiotherapy in rectal cancer patients. Some indicators reveal areas in need of additional efforts, for example to reduce the overall treatment time.
Collapse
Affiliation(s)
- M G Torras
- Clinical Management Department, Institut Català d'Oncologia, Barcelona, Spain.
| | - E Canals
- Radiation Oncology Department, Institut Català d'Oncologia, Girona, Spain
| | - C Muñoz-Montplet
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - A Vidal
- Quality and Results Department, Institut Català d'Oncologia, Girona, Spain
| | - D Jurado
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - A Eraso
- Radiation Oncology Department, Institut Català d'Oncologia, Girona, Spain
| | - S Villà
- Radiation Oncology Department, Institut Català d'Oncologia, Badalona, Spain
| | - M Caro
- Radiation Oncology Department, Institut Català d'Oncologia, Badalona, Spain
| | - J Molero
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - M Macià
- Radiation Oncology Department, Institut Català d'Oncologia, Hospitalet del Llobregat, Barcelona, Spain
| | - M Puigdemont
- Hospital Tumor Registry, Institut Català d'Oncologia, Girona, Spain
| | - E González-Muñoz
- Quality and Results Department, Institut Català d'Oncologia, Girona, Spain
| | - A López
- Cancer Prevention and Control Program, Institut Català d'Oncologia, Hospitalet del Llobregat, Barcelona, Spain
| | - F Guedea
- Radiation Oncology Department, Institut Català d'Oncologia, Barcelona, Spain
| | - J M Borras
- Department of Clinical Sciences, IDIBELL, University of Barcelona, Barcelona, Spain
| |
Collapse
|
7
|
Torras MG, Canals E, Jurado-Bruggeman D, Marín-Borras S, Macià M, Jové J, Boladeras AM, Muñoz-Montplet C, Molero J, Picón C, Puigdemont M, Aliste L, Torrents A, Guedea F, Borras JM. Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice. Transl Oncol 2018; 11:794-799. [PMID: 29704788 PMCID: PMC6058082 DOI: 10.1016/j.tranon.2018.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/29/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- M G Torras
- Clinical Management Department, Institut Català d'Oncologia, Spain.
| | - E Canals
- Radiation Oncology Department, Institut Català d'Oncologia, Girona, Spain
| | - D Jurado-Bruggeman
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - S Marín-Borras
- Radiation Oncology Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - M Macià
- Radiation Oncology Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - J Jové
- Radiation Oncology Department, Institut Català d'Oncologia, Badalona, Spain
| | - A M Boladeras
- Radiation Oncology Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - C Muñoz-Montplet
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Spain
| | - J Molero
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Badalona, Spain
| | - C Picón
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - M Puigdemont
- Hospital Tumor Registry, Institut Català d'Oncologia, Girona, Spain
| | - L Aliste
- Catalonian Cancer Strategy, Department of Health, Barcelona
| | - A Torrents
- Catalonian Cancer Strategy, Department of Health, Barcelona
| | - F Guedea
- Radiation Oncology Department, Institut Català d'Oncologia, Spain
| | - J M Borras
- Catalonian Cancer Strategy, Department of Health, Barcelona; Radiation Oncology Department, Institut Català d'Oncologia, Spain; Clinical Sciences Department, IDIBELL, University of Barcelona
| |
Collapse
|
8
|
Improving radiation oncology through clinical audits: Introducing the IROCA project. Rep Pract Oncol Radiother 2017; 22:408-414. [PMID: 28831281 DOI: 10.1016/j.rpor.2017.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 05/17/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022] Open
Abstract
As radiotherapy practice and processes become more complex, the need to assure quality control becomes ever greater. At present, no international consensus exists with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The present article describes the aims and current status of the international IROCA "Improving Radiation Oncology Through Clinical Audits" project. The project has several important aims, including the selection of key quality indicators, the design and implementation of an international audit, and the harmonization of key aspects of radiotherapy processes among participating institutions. The primary aim is to improve the processes that directly impact clinical outcomes for patients. The experience gained from this initiative may serve as the basis for an internationally accepted clinical audit model for radiotherapy.
Collapse
|