Building Multidisciplinary Collaboration Teams to Facilitate Care
Faculty and Abstracts
Purpose:
Purpose: Improved communication between medical oncology, surgical oncology, and radiation oncology staff to facilitate timely care for patients receiving pelvic radiation through nurse-led multidisciplinary team meetings. Patient populations include female patients with cervical cancer and male patients with prostate cancer requiring collaboration between departments for treatment start dates, pre-radiation procedures, and follow up care.
Methodology: Methodology: Weekly meetings with staff nurses, nurse navigators, midlevel providers, and physicians to review plan of care for newly consulted patients, review status of pre-radiation fiducial marker placement and imaging, facilitate treatment planning and start dates, monitor treatment adherence, and discuss follow up care for patients completing treatment regimen. Dates are tracked with a goal of completing a CT simulation and MRI imaging for treatment planning fourteen days post fiducial marker placement for prostate patients. Cervical patients are tracked throughout the treatment course with a goal of completion of radiation, including external beam and brachytherapy within fifty-six days of starting. Communication and tracking occur through the use of Microsoft teams and flowsheets with pertinent patient information and dates.
Results:
Results: Over a thirty-day period from May 2023, a total of thirty-six prostate patients were consulted. Five of those patients elected to not proceed with radiation therapy. Of those opting for radiation treatment requiring fiducial marker placement, the average number of days between marker placement and treatment planning imaging was sixteen days. The average remains two days above the goal of fourteen days but demonstrates a decrease since starting the prostate team committee in January 2021 when the average was twenty-one days. The average start of treatment for prostate patients receiving fiducial marker placement is fifteen days post imaging. For cervical patients, tracking and statistics require a lengthier examination. A total of sixteen cervical cancer patients were tracked from May to August of 2023 with the average days of treatment from first fraction to final tandem and ring brachytherapy being fifty-four days, falling within the desired goal.
Conclusions:
Conclusions: Factors that contribute to delays in imaging for prostate cancer patients include availability of MRI, travel necessary for patients living in rural areas at a distance from treating facility, and missed appointments. While cervical cancer patients are meeting the goal of completion within fifty-six days on average, barriers to care exist and difficulty collaborating start dates for concurrent chemotherapy and radiation provide opportunities for improvement. With the inclusion of nurse navigators, chemo coordinators, and radiation therapists that help plan treatment schedules, the multidisciplinary teams for prostate and cervical cancer patients may be able to further reduce disruptions to treatment, improving adherence and outcomes.
