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L Brewster Mallalieu, A Kapur, A Sharma, L Potters, A Jamshidi, J Mogavero, J Pinsky

An electronic whiteboard and associated databases for physics workflow coordination in a paperless, multi-site radiation oncology department. L Brewster Mallalieu, A Kapur, A Sharma, L Potters, A Jamshidi, J Mogavero, J Pinsky. North Shore - Long Island Jewish Health System.

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L Brewster Mallalieu, A Kapur, A Sharma, L Potters, A Jamshidi, J Mogavero, J Pinsky

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  1. Anelectronic whiteboard and associated databases for physics workflow coordination in a paperless, multi-site radiation oncology department L Brewster Mallalieu, A Kapur, A Sharma, L Potters, A Jamshidi, J Mogavero, J Pinsky North Shore - Long Island Jewish Health System

  2. FMEA analysis: physics tasks among the highest risks Process delays cause potential safety risks Coordination of physics activities in a multi-site department challenging Motivation for Physics Process Control

  3. Process flow mapping with customized Quality Check Lists Task completion checked and dated Commercial EMR system provides:

  4. Summary views of physics task status for all patients, all physics staff Efficient determination of root causes of delays in physics tasks Statistical analysis of process control with performance metrics EMR system doesn’t provide:

  5. Tools for Process Control

  6. MS Access user interface to SQL database Monitors all planning tasks in summary view Coordination of planning assignments, staff workload tracking Delays flagged with an ON HOLD status Physics whiteboard

  7. Physics whiteboard

  8. Staff workload distribution “Slip Days” metric for Six Sigma analysis: mean, standard deviation, histograms Analyze delays by plan type, disease site, staff, etc. Whiteboard reporting and analysis functions

  9. SlipDays Analysis of Physics Tasks

  10. Machine whiteboard: track and analyze equipment issues

  11. QA incidents reported by staff Cross-functional QM team analyzes incidents to determine root causes and suggest improvements Reviewed incidents broken down using a hierarchical causes data structure QA monitoring database

  12. QA Monitoring Incident Review

  13. Identification of root causes for “Plan not ready for treatment start” incidents

  14. Policies and Procedures • QM analysis leads to new policies • Database for policy documents, review and editing by staff • New policy disseminated to staff via in-service and department blog

  15. EMR doesn’t easily provide workflow coordination and RCA forensics Additional database tools have provided process control data analysis for ongoing streamlining of physics workflow Future: Consolidated, web-based, with electronic interface to EMR data Conclusions

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