From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy

Purpose: The study’s goal was to evaluate the impact of a Radiation Oncologist (RO)—Radiation Therapist (RTT) mentorship on image approval rates for a breast population undergoing radiation therapy in a high-volume practice. The mentorship was undertaken within a large health system in partial fulfi...

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Main Authors: Clodagh Starrs, Sima Rabinowitz, Erin Moshier, Sheryl Green
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Technical Innovations & Patient Support in Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405632424000465
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author Clodagh Starrs
Sima Rabinowitz
Erin Moshier
Sheryl Green
author_facet Clodagh Starrs
Sima Rabinowitz
Erin Moshier
Sheryl Green
author_sort Clodagh Starrs
collection DOAJ
description Purpose: The study’s goal was to evaluate the impact of a Radiation Oncologist (RO)—Radiation Therapist (RTT) mentorship on image approval rates for a breast population undergoing radiation therapy in a high-volume practice. The mentorship was undertaken within a large health system in partial fulfillment of the Expert Practice Module for a Masters (MSc) in Advanced Practice Radiotherapy and Oncology. Methods: Images were retrieved from the MOSAIQ EMR on breast diagnostic code. 1,295 images/115 patients were reviewed pre-mentorship (October 2019-March 2020) and compared with 1,047 images/91patients during/post-mentorship (April 2020-September 2020). The Anderson-Gill (AG) model was used to estimate the hazard ratio for image rejection. Rejected images were classified by reason and compared using Fisher’s exact test. Concordance data (RO/RTT image rejection) were collected during Phase Three of the mentorship. Results: Of 115 patients assessed pre-mentorship, 16 (14 %) had at least 1 image rejected at any session. Of 91 patients assessed post-mentorship, 8 (9 %) had at least 1 image rejected. Likelihood of image rejection decreased by 54 %, with a hazard ratio of 0.46 [95 % CI: 0.24, 0.88]; p = 0.0195. Reasons for image rejection differed pre- and post-mentorship. Poor imaging technique accounted for rejection of 9 of 24 images (37.5 %) before compared to 0 of 11 images (0 %) post-mentorship. Other reasons for image rejection: depth at isocenter (25 % pre-mentorship; 18 % post-mentorship), supraclavicular medial border position (12.5 % vs. 9.09 %), isocenter location (12.5 % vs. 0 %), arm position (4.17 % vs. 54.55 %); hip alignment (8.33 % vs. 18.18 %). Concordance rate was 100 %. Conclusions: The mentorship proved successful in elevating the RTT’s skills and image approval rates, while contributing to improvements in departmental imaging best practices.
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spelling doaj-art-930a6edc0d4647c8adc1e336c92ae4482024-12-16T05:36:27ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242024-12-0132100279From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapyClodagh Starrs0Sima Rabinowitz1Erin Moshier2Sheryl Green3Department of Radiation Oncology, The Mount Sinai Hospital, New York, NY, United StatesInstitute for Health Equity Research, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, N Y, United StatesDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Corresponding author at: Department of Radiation Oncology, The Mount Sinai Hospital, New York, NY, United States.Purpose: The study’s goal was to evaluate the impact of a Radiation Oncologist (RO)—Radiation Therapist (RTT) mentorship on image approval rates for a breast population undergoing radiation therapy in a high-volume practice. The mentorship was undertaken within a large health system in partial fulfillment of the Expert Practice Module for a Masters (MSc) in Advanced Practice Radiotherapy and Oncology. Methods: Images were retrieved from the MOSAIQ EMR on breast diagnostic code. 1,295 images/115 patients were reviewed pre-mentorship (October 2019-March 2020) and compared with 1,047 images/91patients during/post-mentorship (April 2020-September 2020). The Anderson-Gill (AG) model was used to estimate the hazard ratio for image rejection. Rejected images were classified by reason and compared using Fisher’s exact test. Concordance data (RO/RTT image rejection) were collected during Phase Three of the mentorship. Results: Of 115 patients assessed pre-mentorship, 16 (14 %) had at least 1 image rejected at any session. Of 91 patients assessed post-mentorship, 8 (9 %) had at least 1 image rejected. Likelihood of image rejection decreased by 54 %, with a hazard ratio of 0.46 [95 % CI: 0.24, 0.88]; p = 0.0195. Reasons for image rejection differed pre- and post-mentorship. Poor imaging technique accounted for rejection of 9 of 24 images (37.5 %) before compared to 0 of 11 images (0 %) post-mentorship. Other reasons for image rejection: depth at isocenter (25 % pre-mentorship; 18 % post-mentorship), supraclavicular medial border position (12.5 % vs. 9.09 %), isocenter location (12.5 % vs. 0 %), arm position (4.17 % vs. 54.55 %); hip alignment (8.33 % vs. 18.18 %). Concordance rate was 100 %. Conclusions: The mentorship proved successful in elevating the RTT’s skills and image approval rates, while contributing to improvements in departmental imaging best practices.http://www.sciencedirect.com/science/article/pii/S2405632424000465Advanced PracticeBreast image reviewNovice to ExpertMentorshipBest practicesWorkflows
spellingShingle Clodagh Starrs
Sima Rabinowitz
Erin Moshier
Sheryl Green
From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy
Technical Innovations & Patient Support in Radiation Oncology
Advanced Practice
Breast image review
Novice to Expert
Mentorship
Best practices
Workflows
title From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy
title_full From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy
title_fullStr From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy
title_full_unstemmed From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy
title_short From novice to Expert: Reducing Breast Imaging rejection rates through physician mentorship in Advanced Practice Radiation therapy
title_sort from novice to expert reducing breast imaging rejection rates through physician mentorship in advanced practice radiation therapy
topic Advanced Practice
Breast image review
Novice to Expert
Mentorship
Best practices
Workflows
url http://www.sciencedirect.com/science/article/pii/S2405632424000465
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