A Pilot Project to Investigate Radiation Therapist Referrals to an Ad Hoc Supportive Care Oncology Clinic

Purpose/aim: Approximately 400 patients are treated daily within the radiation therapy (XRT) department at the cancer centre where this project took place. As part of their clinical interactions during the treatment delivery process, radiation therapists (MRTs) may refer patients to a third party "RN Assessment Office" for non technical issues. These referrals can result in extended wait times for patients as well as disruptions to the scheduling of MRTs and other health care professionals. This review aimed to identify issues that resulted in third party referrals by MRTs. Data collected may enable insight into the issues that prompt third party referrals and help support MRTs in managing patient issues that are within their scope of practice.

Method/process: A database of XRT patient referrals to the location "RN Assessment Office" in the electronic records (EMRs) was generated for this review. A 4-week period within the previous year was considered suitable by the investigators to produce a representative sample of referrals. Predetermined referral categories were compiled based on the experiences of the investigators. Data were extracted from two sources: (1) the progress note tab within each patient EMR and (2) the comments section of the registered nurses (RNs) Assessment workload location in the EMR systems.

Results/benefits/challenges: Data demonstrated that 17% of the progress notes in the EMR contained MRT documentation before referral. The majority of referrals (29%) were related to patient skin reactions and wound/dressing care.

Conclusions/impact/outcomes: Absence of documentation by MRTs in the EMR impaired the data collection. Anecdotal evidence suggests routine MRT patient assessment during the XRT process. Recommendations related to systematic assessments and documentation procedures may increase MRT documentation. Streamlining the referral processes may improve efficiencies and eliminate redundancies in the workflow of MRTs.