Background and Context:
Canada utilizes a public payer, private health care delivery model, delegated sub-nationally. Effective coordination of uniform access to safe, high quality care can be challenging in this and other similar international models. Quality improvement in radiotherapy (RT) is particularly relevant, since approximately 50% of all cancer patients require RT during their illness. The Canadian Partnership for Quality Radiotherapy (CPQR) is a novel national policy approach employing pan-Canadian engagement to accelerate development and implementation of guidelines for safe, high quality RT. Similar policy strategies can inform comparable international contexts.
Aim:
To create a national culture of safe, high quality RT delivery for all patients; develop and implement a comprehensive sustainable national RT plan for quality and safety.
Strategy/Tactics:
Strategies include: Creating and implementing national quality assurance (QA) guidelines and indicators for RT programs, technical equipment and patient experiences; integrating these into a national accreditation program; developing a national RT incident reporting and learning system.
Programme/Policy Process:
All CPQR products are processed using a feedback loop operational structure. Products are developed, reviewed and validated through community consultation, and endorsed by the steering committee and national stakeholders. Active dissemination strategies have been deployed nationally.
Outcomes/What was learned:
CPQR’s national RT policy approach has been successful due to its interprofessional structure and early engagement. The national RT programmatic QA guidelines and key quality indicators were released in 2011 and 2013, receiving 3849 downloads. Approximately 50% of Canadian RT centres indicated implementing CPQR guidelines and consequently changing local QA practices. 9 QA guidelines for RT equipment were developed and externally validated, 6 are developing. National monitoring and learning structures are developing through an accreditation program and incident reporting repository for sustainability. Knowledge exchange activities included 26 presentations and 10 national/international invited discussions. A national systematic evaluation process will be executed shortly.