Developing An Expedited Stereotactic Treatment Planning Workflow with a Culture of Safety
J Baker1,2*, A Riegel1,2, Y Cao1,2, L Potters1,2, (1) Department of Radiation Medicine, Northwell Health, Lake Success, NY 11042, (2) Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549
Presentations
TU-D1030-IePD-F6-5 (Tuesday, 7/12/2022) 10:30 AM - 11:00 AM [Eastern Time (GMT-4)]
Exhibit Hall | Forum 6
Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being utilized in urgent care settings, but these complex cases take a significant amount of time to plan. We sought to develop a workflow for the most advanced stereotactic treatments, in a timeframe advantageous to the patient, while maintaining our culture of safety.
Methods: A workflow analysis was performed to establish a 48 hour turnaround time from simulation to treatment for SBRT cases. This process needed to respect an opportunity for contour peer-review rounds and our No-Fly policy that insists on an orderly and timely workflow without workarounds.
Results: The established workflow starts with simulation, followed by image fusion within 3-hours. Contours are completed that same day with the case reviewed the next morning at daily peer-review rounds. Plan review and MD sign-off must be completed by 5PM the same day, followed by patient-specific QA that evening for the patient to initiate therapy the next morning. If any item is not completed on time the process is delayed, ensuring patient safety. A planner is on-call for expedited SBRT cases which minimizes the burden and stress of a last minute assignment. This expedited SBRT program was initiated with brain, spine and pancreas cases. In the previous three months,13 cases utilized the expedited approach without No-Fly events. Extra time was allotted for patient reasons five times.
Conclusion: We implemented an expedited SBRT planning process for patient treatment in 48 hours from simulation while respecting our No-Fly safety process and including contour peer-review. This was done minimizing stress in the planning process that could lead to rushed work and risk. Along with the increased indications for SBRT comes increased pressure to start patients’ treatments quickly. Our process of expedited SBRT planning provides a 48 hour turnaround while maintaining a safety program with interlocks avoiding workarounds.
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