title: Optimizing efficiency and safety in a radiation oncology department through the use of ARIA 11 Visual Care Path.
abstract: OBJECTIVE
  Visual Care Path (VCP) is a workflow tool within the ARIA 11 Record and Verify System. The purpose of this study was to quantify the impact of VCP implementation on the metrics of efficiency, safety, and staff satisfaction.
  
  
  METHODS
  Our multidisciplinary quality improvement team reviewed the entire process of patient care and constructed VCP modules to chart serial and parallel events from consultation to treatment completion. A failure mode and effects analysis was performed to identify high-risk tasks within existing patient care workflow. Data on timeliness of task completion were collected for 612 patients (6560 tasks) in 3 time phases: pre-VCP, transition, and post-VCP. Errors detected during a physics plan check were also monitored. A survey about the VCP was distributed to all staff to evaluate the impact of the VCP on the department. Descriptive statistics were calculated for the metrics of efficiency, safety, and staff satisfaction.
  
  
  RESULTS
  Notable improvements in efficiency and safety were observed. Radiation oncologists' compliance with timely completion of the Simulation Preparation VCP tasks increased from 45.9% ± 14.3% during the pre-VCP phase to 85.8% ± 10.9% during the post-VCP phase. Compliance with Treatment Planning VCP tasks also increased from 52.6% ± 9.9% during the pre-VCP phase to 76.0% ± 9.7% during the post-VCP phase. The monthly defect rate (ratio of plans with errors to the total number of plans checked by a physicist) decreased from 19.1% ± 1.3% during the pre-VCP phase to 5.2% ± 4.1% during the post-VCP phase. Ninety-four percent of staff members responded to the VCP survey; more than 80% of respondents found the VCP to have a favorable impact.
  
  
  CONCLUSIONS
  Implementation of the VCP in our department improved workflow efficiency, reduced the number of errors, and was very well received within the department.
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: nataliya.kovalchuk@gmail.com.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Kovalchuk
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Russo
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kachnic
mesh_terms: D006801:Humans; D061214:Patient Safety / Q000592:standards*; D018787:Radiation Oncology / Q000592:standards*