Since 2010, a number of Michener radiation therapy alumni have been meaningfully engaged in the Canadian Partnership for Quality Radiotherapy (CPQR) initiative. As radiation therapists, working in partnership is integral to our ability to provide safe and high quality clinical care to patients. By finding the means to integrate an appreciation for interprofessional collaboration into the education of radiation therapists-in-training, we can reinforce our responsibility to contribute, as health professionals, to the establishment of benchmarks and standards for quality and safety in our professions.
The CPQR was founded as a collaboration between the three professional groups most integrally involved in the delivery of radiation therapy care: radiation oncologists; medical physicists; and radiation therapists. With ongoing support from the Canadian Partnership Against Cancer, the interprofessional and consultative model driving the CPQR initiative has proven effective in meeting its ambitious – but timely – mandates. The work has included the following:
Quality assurance guidelines for radiation programs nationally
By outlining the organizational structure and processes required to ensure safe, high quality radiotherapy, together with key quality indicators for programmatic assessment, the document “Quality Assurance Guidance for Canadian Radiation Treatment Programs” provides national guidelines and indicators to motivate continuous quality improvement. The measure of its uptake is the successful integration into the Radiotherapy module for Accreditation Canada’s Qmentum program.
Technical quality control guidelines for radiation treatment equipment
A suite of 15 equipment-specific guidelines, and overarching technical quality control guidelines, are together termed the Technical Quality Control (TQC) Suite. These provide direction for assuring minimum and optimal performance and safety of radiation treatment technologies in programs across Canada.
National reporting of radiation treatment incidents
CPQR is partnering with the Canadian Institute of Health Information (CIHI) on this project to expand CIHI’s existing National System for Incident Reporting (NSIR) medical incident database. This central repository will provide a tool for radiation programs to report, track and analyze incidents from their own system and anonymously from other Canadian centres.
Evaluation of patient engagement in radiation treatment quality and safety
Patients are the ultimate beneficiaries of safe and effective radiation treatment. CPQR established and is putting into place an approach for measuring and reporting the patient experience in a meaningful way.
The response of the radiation treatment community in Canada to these initiatives is unprecedented and there has been broad uptake of guidelines and indicators nationally and internationally.
Through professional advisory committees, local champions and frequent presentations, CPQR has built a robust network of professionals and trainees with an interest in quality and safety. Community consultation has ensured that all new guidelines, standards and programs are broadly informed and launched with appropriate buy-in. Formal and informal engagement of radiation therapists across the country in CPQR initiatives has resulted in a model of collaboration that can be adapted to other domains. For instance, the Canadian Association of Medical Radiation Technologists (CAMRT) recently initiated discussions to create a similar group within its medical imaging community.
It is important for students – the future of our professions – to be aware of such professional initiatives, and to feel empowered to contribute in the ‘real world’ of practice. Professional skills and engagement sometimes seem tangential to our core clinical skills as health professionals, however it is important to balance core clinical skills with an awareness of the issues facing our professions and our practice at the systemic level. As the profession continues to advance in complexity, autonomy and academic preparation, how do we ensure that we do not become certified to practice without a full appreciation of our operating landscape and climate? Is there a way to integrate this type of content into the curriculum in such a way that it does not become seen by students as the lesser cousin of the medical competency domains? The discussion of competency in quality and safety, specifically, is increasingly being raised in the professional radiation medicine community. For example, there is a belief that professionals should be well versed at entry-to-practice in the quality and safety standards set out by CPQR.
In a short time, CPQR has made great strides in advancing the quality and safety agenda in Canada, and has created an innovative and commendable model for professional collaboration. The formal engagement of medical radiation technologists has been a key enabler of its success, and their voice will continue to impact standards and practices in our field in years to come. Empowering future health professionals to assume ownership of their profession and the care of their patients should be considered an important element of their education, and CPQR’s work and model can serve as a valuable curricular element in this regard.
