RADIATION THERAPISTS ROLE REAPPRAISAL

1
RADIATION THERAPISTS ROLE RE-APPRAISAL

• 1999 2000
• RADIATION ONCOLOGY NETWORK
• NEPEAN AND WESTMEAD

2
RELEVANCE TO PATIENT CARE

• Endless sea of patients waiting for
  radiotherapy
• Waiting times 3 months
• Stakeholders dissatisfied
• Patients
• Radiation Therapists
• Nurses
• Doctors
• CEO
• Departmental work practices inflexible and
  outdated

3
WHY RADIATION THERAPISTS?

• RTs largest group of staff
• One machine closed most of time
• 25 RT positions vacant
• 20 attrition rate of RTs per year
• 20 of available machine time un-utilized
• RTs requested

4
OUTCOMES REQUESTED BY RTS

• Provide best and safest patient care
• Promote communication, teamwork, and integrated
  approach to service delivery
• Recognise value of each of the professional roles
  in service delivery
• Enhance role and maximise job satisfaction for
  RTs

5
RESOURCES UTILIZED FOR PROJECT

• Steering committee (RON Mgt Group)
• RON staff Nepean and Westmead
• Chief Executive Westmead Hosp
• Corporate Secretary/Admin staff Westmead
• Heads of University Schools MRS
• External Consultant
• WSAHS Trust Funds
• Patients who waited while we attended meetings

6
METHODOLOGY

• All sessions on site in normal working hours
• June 1999 full day business analysis workshop
• Attended by all Nepean and Westmead staff
• Identified 284 potential improvement points
• PIP barrier to optimal performance
• Pattern analysis performed
• Three top priorities emerged
• Eliminate fear, blame and conflict
• Improve processes
• Create learning organisation

7
TRAINING SESSIONS BY CONSULTANT

• A. TEAM WORK AND PROBLEM SOLVING WORKSHOPS
• Small groups one day each
• Every RT attended
• Other staff invited
• Clerical staff declined
• B. TEAM LEADER TRAINING
• 15 volunteer RTs and Doctors
• Comprehensive 3 day course
• Formal evaluations by attendees

8
PIP RESOLUTION TEAMS

• PIPs and PIP teams chosen by RTs
• RT Team Leader and up to 4 others
• Non retractable authority delegated to PIP teams
  for level of PIP resolution
• Diagnosis
• Diagnosis and Suggested solution
• Diagnosis and Solution implementation

9
RESULTS ONE YEAR LATER

• PIP outcomes
• Solved 31
• Improved 50
• Same 17.5
• Worse 1.5
• New set of PIPs created for next phase project

10
SPECIFIC OUTCOMES ACHIEVED

• Increased interprofessional Respect
• Culture of fear and blame eliminated
• Many processes streamlined
• Ethics approved Waiting List Management protocol
  in place
• The RON became a learning organisation
• Quarantined budget for RT CPD
• University based Academic RT in place

11
POSTSCRIPT MARCH 2005

• All RON machines open and fully staffed
• RT attrition rate almost zero
• Utilization of machine time exceeds 95
• Radiotherapy Waiting time 2 months
• Process continues