Session Item

RTT track: Risk management/quality management
00:00 - 00:00
Analysis of RT performance using quality indicators derived from automated treatment pathways


Analysis of RT performance using quality indicators derived from automated treatment pathways
Authors: Capone|, Luca(1)*[];Di Minico|, Debora(2);Nardiello|, Barbara(1);Lusini|, Federica(1);Cavallo|, Francesca(2);Tolu|, Barbara(1);
(1)UPMC San Pietro FBF, Radiotherapy, Rome, Italy;(2)UPMC Hillman Cancer Center Villa Maria, Radiotherapy, Mirabella Eclano, Italy;
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Purpose or Objective

Quality indicators are standardized and evidence-based measures of health care that can be used with administrative data to track performance and clinical outcomes. This study analyzes the quality indicators needed in a cancer center accredited by international JCI standards that uses only electronic procedures for managing the patient’s workflow.

Material and Methods

The tasks and activities related to patient flow management have been identified and created digitally in the ARIA computer system (Varian Medical System) according to the workflow carried out based on the JCI standards. Each element of the workflow corresponds to an activity or a task associated with a staff group (Administrative, Medical, Physical, Nurses and Technicians). The time that elapses between one activity and the next has been defined based on the timing found in the department + to carry out the activities themselves, the number of personnel involved and the standards regarding the waiting time of the center. Since the closure of the activities is recorded automatically by the IT system, it was possible to use reports generated by ARIA to calculate the quality indicators. The analysis was based on data regarding the period from January 2019 to August 2019. The quality indicators selected were: Personnel compliance in the use of automated activities; Percentages of completion of the automatic care pathway activities; Waiting times between the different activities of the treatment paths, from the first radiotherapy consultation to the treatment.


The quality indicators taken into consideration are suitable for the activities of the center, managing to highlight the most critical areas and therefore sensitive to improvements.

Staff compliance in the use of automated activities was on average higher (91%) in the first four months compared to the second (80%) with a clear decline in July.

The indicator relating to the percentages of completion of the activities shows the adherence already acquired to the closure of some tasks such as the Time Out of radiotherapy treatments with average completion of 92% and the critical issues related to other activities, for example the closure of the folder has an average completion of about 43%.

The waiting times of the activities are on average always higher than our reference standard, but there is an improvement trend in all the activities analyzed.


The EMR system allows you to accurately analyze the performance delivered in radiotherapy departments, creating versatile quality indicators, which can be customized through the creation of adhoc care pathways, make it possible to achieve high quality levels in the accreditation phase by international commissions and guarantee the monitoring of areas that need improvement.