Abbasi, Ahmed Nadeem

Abrar, Sehrish

Tariq, Maria

English

eCommons@AKU

eCommons@AKU Department of Radiation Oncology Medical College, Pakistan 6-2020 Clinical audit a valuable tool for quality improvement of care: Radiation oncologists' perspective Sehrish Abrar Ahmed Nadeem Abbasi Maria Tariq Follow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_radiat_oncol  Part of the Medical Education Commons, and the Oncology Commons LETTER TO THE EDITORJournal  of  the College of  Physicians and Surgeons Pakistan 2020,  Vol.  30(06):  673-674 673Clinical Audit a Valuable Toolfor Quality Improvement ofCare: Radiation Oncologists’PerspectiveSir,This is to highlight the importance of performing clinical auditsin the field of radiation oncology. Quality services provided byradiotherapy  programmes  are  the  major  determinants  ofoutcome for cancer patients. So, clinical audit projects havebeen started in radiation oncology unit  to  reflect  upon theservices offered by our team.The concept of learning the process of clinical audit duringpost-graduate training period is an important endeavour. Bylearning this concept, we are enhancing skills for the produc-tion of future leaders in the field of research in Pakistan. Ourradiation oncology programme is working on the concept ofadditional learning objective, which is actually not a part of theformal post-graduate training curriculum. But the choice ofadditional learning objective of a trainee should directly trans-late into patient welfare and benefit.  We identify that clinicalaudits are a neglected area in our country and we can improvethe quality of our healthcare by adopting this practice, so wechoose it as an additional learning objective.We wish to highlight the importance of clinical audits in thefield  of  radiation  oncology  as  worldwide  increasing  cancerburden is an alarming situation. In current state of cancer careglobally, around half of the approximately 28 million cancersurvivors undergo radiotherapy (RT) at some point in theirtreatment.1Radiotherapy  plays  a  vital  role  in  the  treatment  of  cancerpatients.  It  is  estimated  that  about  40%  of  cured  cancerpatients undergo radiotherapy in different settings with othermodalities.2,3 Overall, around 50% of all cancer patients needradiation therapy during their course of illness.4Quality services provided by radiation oncology teams have amajor impact on results of cancer patients’ management. Careproviders  are  taking  various  steps;  and  utililising  multiplestrategies to improve quality of care in oncology. Clinical auditis  one  of  the  steps,  which  can  remarkably  help  the  careproviders  to  keep on monitoring leading to  modification incurrent services.5 Clinical audits help reflect upon the servicesoffered and effective utilisation. National Institute for ClinicalExcellence  (NICE)  of  United  Kingdom  defines  audit  as  “aquality improvement process that seeks to improve patientcare and outcomes through systematic review of care againstexplicit criteria and the implementation of change”.6Considering the importance of audit in clinical processes, wedecided to perform an audit of those patients in our set up whotake expert opinion from radiation oncologists in clinics but donot turn up for the treatment. We aimed to find out the reasonsfor the patients being non-compliant to offered treatment byradiation oncologists in our institute. An audit of 180 patientswas performed by our team through telephonic interview toknow the reason for being non-compliant to clinicians' advice.Results of our clinical audit revealed that 85% of patients werenot turned up due to financial constraints on their part, while12%  of  patients  refused  recommended  treatment  due  tomultiple radiation-related myths, and 2% patients were notsatisfied with clinician counselling. Financial constraints andmisconceptions about RT i.e. RT related myths are the twomost important factors that hinder in getting recommendedcancer treatment. Effective efforts are required to overcomecost issues. Physicians need to work on patients’ educationand improving quality of life, while delivering the treatment asper standard treatments.The  future  of  quality  cancer  care  in  Pakistan  lies  in  newresearch and clinical audit projects. So, it is crucial for our post-graduate trainees to learn and lead the clinical audits duringtheir postgraduate training. Improvement in clinical audit willdefinitely improve and enhance postgraduate trainees’ clin-ical acumen and communication skills.7 At the end of the day, itwill lead to quality improvement in overall healthcare of cancerpatients leading to better outcome.CONFLICT OF INTEREST:Authors declared no conflict of interest.AUTHORS’ CONTRIBUTION:SA: Conducted the clinical audit and played major role inprocess of writing.ANA: Helped in revising the manuscript critically and approvedthe final version to be published.MT: Helped in data collection process for clinical audit.REFERENCESBorras  JM,  Barton  M,  Grau  C,  Corral  J,  Verhoeven  R,1.Lemmens V,  et  al.  The impact  of  cancer  incidence andstage on optimal utilization of radiotherapy: Methodology ofa population based analysis by the ESTRO-HERO project.Radiother Oncol 2015; 116(1):45-50.DeVita VT, Jr., Rosenberg SA. Two hundred years of cancer2.research. N Engl J Med 2012; 366(23):2207-14.Delaney G, Jacob S, Featherstone C, Barton M. The role of3.radiotherapy  in  cancer  treatment:  estimating  optimalutilization  from  a  review  of  evidence-based  clinicalguidelines. Cancer 2005; 104(6):1129-37.Begg  AC,  Stewart  FA,  Vens  C.  Strategies  to  improve4.radiotherapy with targeted drugs. Nat Rev Cancer  2011;11(4):239-53.Limb C, Fowler A, Gundogan B, Koshy K, Agha R. How to5.LETTER TO THE EDITORJournal  of  the College of  Physicians and Surgeons Pakistan 2020,  Vol.  30(06):  673-674674conduct a clinical audit and quality improvement project.Int J Surg Oncol (NY) 2017; 2(6):e24.Excellence NIfC. Principles for best practice in clinical audit:6.Radcliffe Publishing; 2002.Johnston  G,  Crombie  I,  Alder  E,  Davies  H,  Millard  A.7.Reviewing  audit:  Barriers  and  facilitating  factors  foreffective clinical audit. Qual Health Care 2000; 9(1):23-36.Sehrish  Abrar,  Ahmed  Nadeem  Abbasi  and  Maria  Tariq..................................................................................Department  of  Oncology,  The  Aga  Khan  University  Hospital,Karachi,  Pakistan..................................................................................Correspondence  to:  Sehrish  Abrar,  Department  of  Oncology,The  Aga  Khan  University  Hospital,  Stadium  Road,  Karachi,PakistanE-mail:  sehrish.abrar@aku.edu...................................................................Received: June 27, 2019;   Revised: August 22, 2019;Accepted:  August  26,  2019DOI:  https://doi.org/10.29271/jcpsp.2020.06.673

Clinical audit a valuable tool for quality improvement of care: Radiation oncologists\u27 perspective

https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1078&amp;context=pakistan_fhs_mc_radiat_oncol

Clinical audit a valuable tool for quality improvement of care: Radiation oncologists\u27 perspective

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