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Magon H, Smith J, Besson J, Hau E, Taylor S, Ruben J, Jones D, Mabb K, Feldman J, Gholam Rezaei L, Lee YY. Adapting to change: exploring perceptions and demands of the coronavirus (COVID-19) workforce changes - an Australian multi-institutional radiation oncology survey. AUST HEALTH REV 2024; 48:388-395. [PMID: 38467124 DOI: 10.1071/ah23183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
Objective To evaluate the perceptions of the coronavirus disease 2019 (COVID-19) initiated workplace strategies implemented in radiation oncology departments across Australia. Methods A multidisciplinary team from Princess Alexandra Hospital developed a survey to address the impact of the pandemic strategies on areas such as patient care, staff education, well-being, flexible working arrangements, and research. The survey was conducted from November 2020 to April 2021. Results Out of 210 respondents from seven institutions, 45% reported burnout and 57% experienced work work-related stress. A significant majority of respondents were in favour of continued remote work (86%, 131/153). Radiation oncologists identified administrative or non-clinical work (92%, 34/37), telehealth clinics (32%, 12/37), or radiation therapy planning (22%, 8/37) as suitable for remote work. Additionally, 54% (21/39) of the radiation oncologists plan to use telehealth more frequently, with 67% (26/39) feeling more confident with the technology. The majority (81%, 171/210) of participants favoured continuation of hybrid in-person and virtual meetings. Virtual solutions were adopted for quality assurance activities (72%, 118/165) and 52% (60/116) indicated preference for ongoing utility of virtual platforms. However, 38% (79/210) of the respondents expressed concerns about the negative impact on junior staff training. Conclusion These findings reveal a strong inclination towards technological advancements and remote work arrangements to enable flexible working conditions. Our study suggests the need for ongoing reforms, focusing on improving clinical service delivery efficiencies and enhancing job satisfaction among clinicians.
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Affiliation(s)
- Honor Magon
- Digital Health and Informatics, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld 4102, Australia
| | - Justin Smith
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia; and Faculty of Medicine, University of QLD, Brisbane, Qld, Australia; and College of Medicine and Dentistry, James Cook University, Townsville, Qld, Australia
| | - Jacqueline Besson
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia
| | - Eric Hau
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia; and Blacktown Haematology and Oncology Cancer Cente, Blacktown Hospital, Sydney, NSW, Australia; and Westmead Institute of Medical Research, Sydney, NSW, Australia; and Westmead Medical School, University of Sydney, Sydney, NSW, Australia
| | - Suzanne Taylor
- Faculty of Medicine, University of QLD, Brisbane, Qld, Australia; and Department of Radiation Oncology, Princess Alexandra Hospital Raymond Terrace Campus, Brisbane, Qld, Australia
| | | | - Diana Jones
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia
| | - Kira Mabb
- Department of Nutrition and Dietetics, Princess Alexandra Hospital Ipswich Road Campus, Brisbane, Qld, Australia
| | - Jamie Feldman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital Ipswich Road Campus, Brisbane, Qld, Australia
| | - Leily Gholam Rezaei
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia
| | - Yoo Young Lee
- Department of Radiation Oncology, Princess Alexandra Hospital, Ipswich Road Campus, Brisbane, Qld, Australia; and Faculty of Medicine, University of QLD, Brisbane, Qld, Australia
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Saito M, Tamamoto T, Kawashiro S, Umezawa R, Matsuda M, Tohyama N, Katsuta Y, Kanai T, Nemoto H, Onishi H. Current status of remote radiotherapy treatment planning in Japan: findings from a national survey†. JOURNAL OF RADIATION RESEARCH 2024; 65:127-135. [PMID: 37996096 PMCID: PMC10803164 DOI: 10.1093/jrr/rrad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/04/2023] [Accepted: 10/14/2023] [Indexed: 11/25/2023]
Abstract
The purpose of this study was to investigate the status of remote-radiotherapy treatment planning (RRTP) in Japan through a nationwide questionnaire survey. The survey was conducted between 29 June and 4 August 2022, at 834 facilities in Japan that were equipped with linear accelerators. The survey utilized a Google form that comprised 96 questions on facility information, information about the respondent, utilization of RRTP between facilities, usage for telework and the inclination to implement RRTPs in the respondent's facility. The survey analyzed the utilization of the RRTP system in four distinct implementation types: (i) utilization as a supportive facility, (ii) utilization as a treatment facility, (iii) utilization as a teleworker outside of the facility and (iv) utilization as a teleworker within the facility. The survey response rate was 58.4% (487 facilities responded). Among the facilities that responded, 10% (51 facilities) were implementing RRTP. 13 served as supportive facilities, 23 as treatment facilities, 17 as teleworkers outside of the facility and 5 as teleworkers within the facility. In terms of system usage between supportive and treatment facilities, 70-80% of the participants utilized the system for emergencies or as overtime work for external workers. A substantial number of facilities (38.8%) reported that they were unfamiliar with RRTP implementation. The survey showed that RRTP utilization in Japan is still limited, with a significant number of facilities unfamiliar with the technology. The study highlights the need for greater understanding and education about RRTP and financial funds of economical compensation.
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Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
| | - Tetsuro Tamamoto
- Department of Medical Informatics, Nara Medical University Hospital, 840 Shijyo-cho, Kashihara, Nara 634-8521, Japan
| | - Shohei Kawashiro
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, Yamagata 990-9585, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Masaki Matsuda
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
| | - Naoki Tohyama
- Division of Medical Physics, Tokyo Bay Makuhari Clinic for Advanced Imaging, Cancer Screening, and High-Precision Radiotherapy, 1-17 Toyosuna, Mihama-ku, Chiba, Chiba 261-0024, Japan
| | - Yoshiyuki Katsuta
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Takayuki Kanai
- Department of Radiation Oncology, Tokyo Women's Medical University, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo 162-8666, Japan
| | - Hikaru Nemoto
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
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Sohn J, Polizzi M, McDonagh PR, Guy C, Datsang R, Weiss E, Kim S. Shallow kinetics induced by a metronome (SKIM): A novel contactless respiratory motion management. J Appl Clin Med Phys 2023; 24:e14147. [PMID: 37672210 PMCID: PMC10691643 DOI: 10.1002/acm2.14147] [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: 03/05/2023] [Revised: 06/26/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES As an alternative to conventional compression amidst the COVID-19 pandemic, we developed a contactless motion management strategy. By increasing the patient's breathing rate to induce shallow breathing with the aid of a metronome, our hypothesis is that the motion magnitude of the target may be minimized without physical contact or compression. METHODS Fourteen lung stereotactic body radiation therapy (SBRT) patients treated under fast shallow-breathing (FSB) were selected for inclusion in this retrospective study. Our proposed method is called shallow kinetics induced by a metronome (SKIM). We induce FSB by setting the beats-per-minute (BPM) high (typically in the range of 50-60). This corresponded to a patient breathing rate of 25-30 (breathing) cycles per minute. The magnitude of target motion in 3D under SKIM was evaluated using 4DCT datasets. Comparison with free breathing (FB) 4DCT was also made for a subset for which FB data available. RESULTS The overall effectiveness of SKIM was evaluated with 18 targets (14 patients). Direct comparison with FB was performed with 12 targets (10 patients). The vector norm mean ± SD value of motion magnitude under SKIM for 18 targets was 8.2 ± 4.1 mm. The mean ± SD metronome BPM was 54.9 ± 4.0 in this group. The vector norm means ± SD values of target motion for FB and SKIM in the 12 target sub-group were 14.6 ± 8.5 mm and 9.3 ± 3.7 mm, respectively. The mean ± SD metronome BPM for this sub-group was 56.3 ± 2.5. CONCLUSION Compared with FB, SKIM can significantly reduce respiratory motion magnitude of thoracic targets. The difference in maximum motion reduction in the overall vector norm, S-I, and A-P directions was significant (p = 0.033, 0.042, 0.011). Our proposed method can be an excellent practical alternative to conventional compression due to its flexibility and ease of implementation.
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Affiliation(s)
- James Sohn
- Department of Radiation OncologyNorthwestern Memorial HospitalNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Mitchell Polizzi
- Department of Radiation OncologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Philip Reed McDonagh
- Department of Radiation OncologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Christopher Guy
- Department of Radiation OncologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Rabten Datsang
- Department of Radiation OncologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Elisabeth Weiss
- Department of Radiation OncologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Siyong Kim
- Department of Radiation OncologyVirginia Commonwealth UniversityRichmondVirginiaUSA
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Chan K, Timotin E, Chung P, Han K, Milosevic M, Schnarr K, Sur R, Bosche J, Harnett N. A two-center experience: The impact of COVID-19 on two brachytherapy programs in Ontario - virtual care, service suspension and radiation therapy workflow. J Med Imaging Radiat Sci 2023; 54:436-445. [PMID: 37357051 PMCID: PMC10289124 DOI: 10.1016/j.jmir.2023.05.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/09/2023] [Accepted: 05/23/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Most brachytherapy (BT) procedures require general anesthesia and are therefore considered aerosol generating medical procedures (AGMPs). The COVID-19 pandemic impacted BT as services were prioritized by balancing the harm associated with COVID-19 infection versus the effect of delay of potentially curative treatment. This article summarizes the impact of the pandemic on BT programs in two cancer centers in a Canadian province. METHODS As part of a quality assurance project, a retrospective study was conducted for the first five months of the pandemic (March 1 to July 31, 2020). Chart review and COVID-19 related mitigation strategies were identified by BT Clinical Specialist Radiation Therapists (bCSRT) in each center using electronic medical records, departmental reports, policies and procedures. RESULTS Impact included start of virtual care (VC), shortened fractionation, suspension of services and workflow changes. Both centers implemented VC strategies to reduce clinic visits: "same-day size and treat" strategy for post-operative endometrial cancer patients and virtual patient education for all patients. BT services that were suspended were low-dose-rate and high-dose-rate (HDR) prostate treatments (Center 1), lung and esophagus HDR treatments (Center 2). Workflow changes that affected staff and patients in both centers included COVID-19 screening and the use of personal protective equipment. The centers were marginally different in workflow adjustments for AGMP procedures. Those considered high-risk AGMP and low-risk cancer were suspended temporarily with alternate treatment strategies sought for some patients. Others had temporizing treatment such as androgen deprivation therapy to facilitate oncological safe deferral of procedures. CONCLUSION Both BT programs delivered treatment to most patients with minimal delays and cancellations, where feasible. Some of the pandemic workflow changes continued to the current state of the pandemic. Long-term follow-up is needed to assess the impact of COVID-19 and treatment interruptions on oncologic outcomes.
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Affiliation(s)
- Kitty Chan
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
| | | | - Peter Chung
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Kathy Han
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Michael Milosevic
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Kara Schnarr
- Juravinski Cancer Centre, Hamilton, Ontario, Canada; Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Ranjan Sur
- Juravinski Cancer Centre, Hamilton, Ontario, Canada; Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Joanne Bosche
- Department of Anesthesia, University Health Network, Toronto, Ontario, Canada
| | - Nicole Harnett
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
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Jacqmin DJ, Crosby JSM. The impact of COVID-19 on a high-volume incident learning system: A retrospective analysis. J Appl Clin Med Phys 2022; 23:e13653. [PMID: 35616007 PMCID: PMC9278685 DOI: 10.1002/acm2.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/05/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The purpose of this work was to assess how the coronavirus disease 2019 (COVID-19) pandemic impacted our incident learning system data and communicate the impact of a major exogenous event on radiation oncology clinical practice. METHODS Trends in our electronic incident reporting system were analyzed to ascertain the impact of the COVID-19 pandemic, including any direct clinical changes. Incident reports submitted in the 18 months prior to the pandemic (September 14, 2018 to March 13, 2020) and reports submitted during the first 18 months of the pandemic (March 14, 2020 to September 13, 2021) were compared. The incident reports include several data elements that were evaluated for trends between the two time periods, and statistical analysis was performed to compare the proportions of reports. RESULTS In the 18 months prior to COVID-19, 192 reports were submitted per 1000 planning tasks (n = 832 total). In the first 18 months of the pandemic, 147 reports per 1000 planning tasks were submitted (n = 601 total), a decrease of 23.4%. Statistical analysis revealed that there were no significant changes among the data elements between the pre- and during COVID-19 time periods. An analysis of the free-text narratives in the reports found that phrases related to pretreatment imaging were common before COVID-19 but not during. Conversely, phrases related to intravenous contrast, consent for computed tomography, and adaptive radiotherapy became common during COVID-19. CONCLUSIONS The data elements captured by our incident learning system were stable after the onset of the COVID-19 pandemic, with no statistically significant findings after correction for multiple comparisons. A trend toward fewer reports submitted for low-risk issues was observed. The methods used in the work can be generalized to events with a large-scale impact on the clinic or to monitor an incident learning system to drive future improvement activities.
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Affiliation(s)
- Dustin J. Jacqmin
- Department of Human OncologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Jennie S. M. Crosby
- Department of Human OncologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Czmielewski C, Gallina V, Tripoli D, Lenards N, Hunzeker A, Zeiler S. Analyzing changes in radiotherapy treatment planning error reporting during the COVID-19 pandemic. Med Dosim 2022; 47:248-251. [PMID: 35584973 PMCID: PMC8995205 DOI: 10.1016/j.meddos.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 11/18/2022]
Abstract
The 2019 coronavirus (COVID-19) pandemic has affected medical physics and radiation oncology departments and the delivery of radiation therapy. Among the changes implemented in response to the onset of the pandemic was a shift to remote treatment planning by health care institutions. The purpose of this study was to determine whether the overall frequency of errors changed after the implementation of remote radiation therapy treatment planning during the COVID-19 pandemic. Reported incidents were obtained from an incident reporting database operated by a multisite cancer care facility in the Northeast. Researchers compared the frequency of reported events in a period prior to the start of the pandemic (March 2019 to February 2020) with a period after the onset of the pandemic (March 2020 to February 2021). No significant increase in reported incidents was detected suggesting the efficiency and safety of remote radiotherapy treatment planning.
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Affiliation(s)
| | - Victoria Gallina
- Medical Dosimetry Program, University of Wisconsin-La Crosse, WI 54601, USA
| | - Dylan Tripoli
- Medical Dosimetry Program, University of Wisconsin-La Crosse, WI 54601, USA
| | - Nishele Lenards
- Medical Dosimetry Program, University of Wisconsin-La Crosse, WI 54601, USA
| | - Ashley Hunzeker
- Medical Dosimetry Program, University of Wisconsin-La Crosse, WI 54601, USA
| | - Sabrina Zeiler
- Medical Dosimetry Program, University of Wisconsin-La Crosse, WI 54601, USA
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Lincoln H, Khan R, Cai J. Telecommuting: A viable option for medical physicists amid the COVID-19 outbreak and beyond. Med Phys 2020; 47:2045-2048. [PMID: 32335929 PMCID: PMC7267135 DOI: 10.1002/mp.14203] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Affiliation(s)
- Holly Lincoln
- Department of Therapeutic RadiologyYale New Haven HospitalNew HavenCT06510USA
| | - Rao Khan
- Department of Radiation OncologyWashington University School of Medicine in St. LouisSt. LouisMO63110USA
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