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Overall patient care (RT specific)

 

Radiation therapists ensure patients receive high overall quality of care through coordinated services, resources and collaboration with other healthcare professionals

 

+ Overall care

  • Cancer is a complex disease affecting an individual's physical, mental, emotional, and spiritual well-being
  • Research has established that coordinated, collaborative service delivery improves clinical (i.e., mortality, length of stay, readmission) and patient-reported (i.e., satisfaction, health related quality of life) outcomes for a variety of acute and chronic conditions.1
  • Good quality overall care begins with an understanding of the individual patient and the care they are receiving.
    • Some patients may be receiving chemotherapy prior to, following, or at the same time as radiation therapy
    • Radiation therapy, chemotherapy and other treatments present potential for a range of early and late side effects
    • Patients with cancer often access care from multiple resources over the course of their treatment2

 

  • A program of care is developed with the multidisciplinary team that outlines all aspects of a patient’s care and the elements of coordination among the team.
    • Outcomes are improved when patients receive cancer care from a highly functioning, multidisciplinary care team guided by a written plan of care3,4

 

  • Communication is a foundation for efficient and coordinated deployment of an overall program of care with a multidisciplinary team.5

+ Coordination of care

  • In their role as patient advocates, Radiation therapists have a professional responsibility to see that patients are receiving the most appropriate care.
  • Studies have shown that patients place a high value on their time, and expect that the care they will receive will be well coordinated and efficient.6
  • Coordination of care helps to make sure patients are well-informed throughout that journey and ensures the flow of information within and across treatment teams.7
  • Once a program of care has been developed, in conjunction with other healthcare providers, Radiation therapists ensure that the program is implemented in a timely and safe fashion, including:
    • Providing care as part of daily treatment or by participating in a scheduled weekly review model8
    • Identifying symptoms or concerns that require further investigation or management
    • Anticipating elements of overall care that require coordination
    • Collaborating by initiating contact and making referrals to the appropriate healthcare providers
    • Monitoring and facilitating interventions recommended by the healthcare team – helping to reinforce, assess effectiveness and follow up
    • Following up with the appropriate healthcare professionals to confirm the delivery of care matches the goals of the program
    • Maintaining complete and up-to-date documentation of the program and the services accessed by the patient as a resource for those who wish to review the program of care
    • Supporting informational, management and relational continuity of care by maintaining electronic or patient held records1

+ Communicating with the patient

  • Radiation therapists ensure they have an understanding of the overall program for the patient’s care and communicate this to the patient
  • The regular contact Radiation therapists have with their patients provides an opportunity to build relationships and gain understanding and appreciation for patient needs and preferences.
    • Discussions with patients should include a chance for the patient to ask questions and address concerns about the care they are receiving
    • An understanding of specific patient needs will aid to improve and better coordinate care, while avoiding general assumptions about patient needs9

 

  • A comprehensive and holistic approach to patient communication and involvement in their own care should take into account:9
    • What patients know already
    • What they still want to know
    • How they are affected by pre-existing symptoms
    • Emotional concerns
    • Family and employment concerns
    • Concerns about specific risks associated with the treatment

 

  • The use of a symptom assessment tool may provide a basis for an assessment of the patient’s needs and concerns.9,10
    • This could entail a simple checklist that is used to guide patient discussion

 

  • In addition, patients may be unaware that these services and resources could be available to them, and how to go about accessing them.
    • Radiation Therapists discuss options with patients and make information available to them

+ References

  1. Gagliardi AR, Dobrow MJ, Wright FC. How can we improve cancer care? A review of interprofessional collaboration models and their use in clinical management. Surg Oncol 2011;20(3):46-54.
  2. Clifford Chao KS, Perez CA, Brady LW. Radiation Oncology Management Decisions 3rd ed. Lippincott Williams & Wilkins; 2011.
  3. Taylor C, Munro AJ, Glynne-Jones R, et al. Multidisciplinary team working in cancer: what is the evidence? BMJ 2010;340:c951.
  4. Patlak M, Balogh E, Nass S; Institute of Medicine. Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care: Workshop Summary. Washington, DC: The National Academies Press; 2011. Available at: http://www.nap.edu/catalog. php?record_id¼13155. Accessed August 1, 2011.
  5. Hassey Dow K, Hilderley LJ. Nursing Care in Radiation Oncology 2nd ed. Philadelphia PA: W.B. Saunders; 1992.
  6. Gesell S, Gregory N. Identifying Priority Actions for Improving Patient Satisfaction With Outpatient Cancer Care. J Nurs Care Qual 2004;19(3):226-233.
  7. Aranda S. The importance of cancer care coordination. Incite 2012;9. Available at: http://www.cancerinstitute.org.au/incite/issue-9/the-importance-of-cancer-care-coordination. Accessed March 20, 2013.
  8. Alfieri F, Le Mottee MA, Arifuddin A, et al. Radiation therapist-led weekly patient treatment reviews. Radiographer 2009;56(3):44-48.
  9. Faithfull S, Wells M (Eds). Supportive care in radiotherapy. Toronto, ON: Elsevier Health Sciences; 2003.
  10. Cancer Care Ontario. Edmonton Patient Assessment System. Available at: https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13262. Accessed March 20, 2013.

 

Validation

October 16, 2013

 

 
Canadian Association of Medical Radiation Technologists
85 Albert St, Suite 1000, Ottawa, ON, K1P 6A4
phone: 613 234-0012 / 800 463-9729
fax: 613 234-1097
www.camrt.ca