Improving Quality of Radiotherapy Care Across Ontario Using a Community of Practice Approach
Notice bibliographique
Résumé
Background: Communities of Practice (CoPs) are defined as “a group of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis”. This concept was developed by Wegner and Lave in 1991, based on the theory that learning is more than just acquiring knowledge, but rather involves being socialized into a practice and developing an identity within a community. Cancer Care Ontario (CCO) is the provincial governments advisor on the cancer system and this work documents CCO's use of CoPs to help advance the quality of care in radiotherapy in Ontario, Canada. Aim: After the divestment of radiotherapy care from a centralised structure into individual hospitals in 2003/2004, there was a marked decrease in communication between the 14 Regional Cancer Centres (RCCs) in Ontario. As a means to rebuild the sense of community among radiation medicine programs (encompassing oncologists, physicists and radiation therapists), and to facilitate communication between the RCCs, the Radiation Treatment Program (RTP) at CCO developed and organized a CoP program. The three aims were knowledge creation, knowledge transfer and exchange (KTE), and community building. The ultimate goal was to improve the safety and quality of radiotherapy by reducing variation in practice between centers. Methods: Seven CoPs have been established since 2010; 3 are disease specific (head and neck, gynecologic and lung cancers) with multidisciplinary representation from oncologists, physicists, and radiation therapists. The other 4 CoPs are single-discipline (radiation therapy, physics, radiation safety officers, clinical specialist radiation therapists) to allow for practice specific knowledge-sharing and innovation. All CoPs are led and driven by volunteer members who identify and prioritize key quality issues and select corresponding projects to pursue. Results: CCO's CoPs have produced several knowledge products, including endorsed clinical guidance documents (5), and practical implementation tools (5), with over 20 additional products currently in development. Members have delivered numerous international and national KTE presentations and hosted 51 workshops. CoP guidance documents have 1: Improved safety ( “Implementation Strategy for Radiation Safety Straps” with 100% implementation across RCCs) 2: Standardized care ( “Contouring Nomenclature - Head and Neck Cancer”) with adoption of recommendations province-wide 3: Supported infrastructure improvements (“ MRI Simulation guideline document”). Conclusion: Overall, the RTP's CoP program has been effective in achieving its main three aims: knowledge creation, KTE, and community building. This approach of a member-driven voluntary CoP should be explored and modeled in other healthcare settings as a means to develop and share knowledge, reduce variation in care, standardize practice and improve patient care.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».