Ten-year results of quality assurance in radiotherapy chart round

BMC Health Serv Res. 2013 Apr 23:13:148. doi: 10.1186/1472-6963-13-148.

Abstract

Background: The Royal Australian and New Zealand College of Radiologists (RANZCR) initiated a unique instrument to audit the quality of patient notes and radiotherapy prescriptions. We present our experience collected over ten years from the use of the RANZCR audit instrument.

Methods: In this study, the results of data collected prospectively from January 1999 to June 2009 through the audit instrument were assessed. Radiotherapy chart rounds were held weekly in the uro-oncology tumour stream and real time feedback was provided. Electronic medical records were retrospectively assessed in September 2009 to see if any omissions were subsequently corrected.

Results: In total 2597 patients were audited. One hundred and thirty seven (5%) patients had one hundred and ninety nine omissions in documentation or radiotherapy prescription. In 79% of chart rounds no omissions were found at all, in 12% of chart rounds one omission was found and in 9% of chart rounds two or more omissions were found. Out of 199 omissions, 95% were of record keeping and 2% were omissions in the treatment prescription. Of omissions, 152 (76%) were unfiled investigation results of which 77 (51%) were subsequently corrected.

Conclusions: Real-time audit with feedback is an effective tool in assessing the standards of radiotherapy documentation in our department, and also probably contributed to the high level of attentiveness. A large proportion of omissions were investigation results, which highlights the need for an improved system of retrieval of investigation results in the radiation oncology department.

MeSH terms

  • Australien
  • Clinical Audit / methods*
  • Commission on Professional and Hospital Activities
  • Female
  • Humans
  • Male
  • Medical Records / standards*
  • Neuseeland
  • Peer Review, Health Care / methods
  • Peer Review, Health Care / standards*
  • Prospective Studies
  • Quality Assurance, Health Care / statistics & numerical data*
  • Quality Assurance, Health Care / trends*
  • Radiotherapy / standards*