Framework Development: Standardizing Definition of Advanced Practice Radiation Therapy Activities for Clinical Workload Quantification

• Published in: Technical innovations & patient support in radiation oncology 2024-03, Vol.29, p.100238-100238, Article 100238
• Main Authors: Chan, Kitty, Chan, Biu, Linden, Kelly, Erler, Darby, D'Alimonte, Laura, Kong, Vickie, Kraus, Julie, Harnett, Nicole
• Format: Article
• Language: English
• ISSN: 2405-6324; 2405-6324
• DOI: 10.1016/j.tipsro.2024.100238

•First systematic attempt to measure the clinical impact of advanced practice (AP) radiation therapy roles.•Consensus building involving 20 advanced practice radiation therapists and 14 their managers.•List of 20 advanced practice (AP) activities and its definitions was generated.•Proposed framework that allows standardized and continuous monitoring of AP clinical impact. Advanced practice (AP) in radiation therapy (RT) is being implemented around the globe. In an effort to advance the understanding of the similarities and differences in APRT roles in Ontario, Canada, a community of practice (CoP) sought ways to provide quantitative data on the nature of APRT clinical activities and the frequency with which these activities were being executed. In 2017, a consensus building project involving 20 APRTs and 14 radiation therapy (RT) department managers in Ontario was completed to establish a mechanism to quantify APRTs’ clinical impact. In Round 1 & 2, expert feedback was gathered to generate an Advanced Practice (AP) Activity List. In Round 3: 20 APRTs completed an online survey to assess the importance and applicability of each AP Activity to their role using Likert scale (0–5). A final AP Activity List & Definitions was generated. Round 1: Forty-seven AP activities were identified. Round 2: 3/14 RT managers provided 145 feedback statements on Round 1 AP Activity List. The working group used RT managers’ feedback to clarify AP activities and definitions, specifically merging 33 unique AP activities to create 11 inclusive AP activities and eliminating 8 activities identified from Round 1. The most inclusive AP activity created was #1 New Patient Consultation, this AP Activity is merged from 7 unique AP activities. Incorporating RT managers’ feedback with the internal AP clinical workload lists from 2 Ontario cancer centres resulted in a revised AP Activity List with 20 AP inclusive activities. Round 3: 14/20 APRTs provided Likert scores on this revised list. The most applicable AP activities (mean score) were #16 Technical Consultation (4.0), #15 Contouring Target Volume (3.8) and #2 Planning Consultation (3.8); the least applicable was #18 MR Applicator Assessment (0.9). This is the first systematic attempt to build consensus on AP clinical activities. Non-clinical APRT activities related to research, education, innovation, and program development were not in the scope of this project.The Final AP Activity List & Definitions serves as a framework that allow