Abstract
PURPOSE: To evaluate the impact of a digital whiteboard system integrated with data from the oncology information system (OIS) on the urgency of physics quality assurance (QA) tasks in the radiation oncology department. METHODS: Quality check list (QCL) items in the Mosaiq OIS corresponding to eight discrete, sequential steps in the treatment planning process were created. A whiteboard to graphically display active QCLs automatically and in real time was implemented in March 2020 using R shiny. QCL data with completion status were collected in two 12-month time periods before and after whiteboard implementation: January 2019-December 2019 and July 2020-June 2021. For all plans requiring patient-specific QA, we recorded when each plan was available for physics QA and which treatments started the following day. We further classified those plans into four categories (urgency levels 1-4 with 4 being the most urgent) depending on how much time was available to perform QA. We compared the proportion of these next-day QAs in each category between time periods accounting for plan type, day of the week, and time of year. RESULTS: Overall QA numbers were similar between time periods with 797 and 765 QAs total. The total proportion of next-day QA decreased by 27% and the proportions of urgency levels 1 and 4 both showed significant decreases after whiteboard implementation of 29.2% and 54.9%, respectively ( p < 0.05 ). All plan types had reduced proportions of next-day QAs, especially nonstereotactic body radiation therapy (non-SBRT) (30.3% decrease, p < 0.05 ). Fridays and the months of October-December had the highest proportion of next-day QAs but showed significant reductions of 19.1% and 40.6% in the proportion of next-day QAs, respectively ( p < 0.05 ). CONCLUSIONS: The integrated whiteboard system significantly reduced the proportion of last-minute physics work, increasing patient safety. Advantages of the integrated whiteboard were low cost, low overhead with automatic interface to the OIS, and concurrent user support.