Improving Quality of Radiotherapy Care Across Ontario Using a Community of Practice Approach
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".