It Only Takes a Minute: The Development and Implementation of a Patient Experience Survey in Radiation Therapy.

INTRODUCTION: Health care services use surveys to assess patient satisfaction and identify areas for improvement. While it is important to assess patient satisfaction to ensure their needs are met, lengthy questionnaires with closed-ended questions often focus on areas that may be considered important by institutions rather than patients. Recently, focus has shifted toward patient and caregiver experience, which institutions address via appreciative inquiry. The aim of this initiative was the development of a patient experience survey (PES) for radiation therapy patients and caregivers which would allow them to express their opinions and priorities. This patient feedback would then be addressed through quality improvement (QI) projects geared toward improving the overall patient and caregiver experience in radiation therapy. METHODS: A three-question minute survey was developed for use as a PES in the radiation therapy department of an academic oncology program located in a large metropolitan area. Feedback was obtained from patient education and person-centred care experts, as well as 10 radiation therapy patients. All feedback was incorporated to create the final PES; respondents rated their agreement on a five-point Likert scale with the statement "My overall experience in Radiation Therapy was great" and two open-ended questions allowed them to highlight departmental strengths and areas for improvement. An initial 3-month pilot was conducted where PESs were available on a self-serve basis to patients and caregivers in waiting areas and at radiation therapy treatment units. All responses were anonymous and completed surveys were returned via drop boxes. Descriptive statistics and thematic analysis were used to analyse responses. RESULTS: A total of 86 surveys were returned. Of those, 80 (93%) responded to the Likert scale question with 83% agreeing or strongly agreeing that their experience in radiation therapy was great. Several strengths were identified by respondents including teamwork, professionalism, and knowledge. Areas identified for improvement included management of appointment delays and communication of delays to patients, as well as environmental improvements. CONCLUSIONS: Although most respondents reported a favourable experience, this pilot demonstrated the minute survey can identify areas for improvement that can be addressed through QI. Including the patient perspective in QI is evidenced to enhance its outcome and aligns with institutional, provincial, and national strategic goals of improving the quality of cancer care through patient engagement.

Factors Affecting Treatment Outcome in Elderly Head and Neck Cancer Patients: A Retrospective Pilot Study.

BACKGROUND: Head and neck cancer (HNC), the fifth most common cancer worldwide, is a complicated category of diseases comprised of cancers of the oral cavity, oropharynx, nasopharynx, hypopharynx, and larynx. Management of HNC can be very complex, with surgery, chemotherapy, and radiation therapy often used in combination to achieve optimal results. The optimal combination of therapies to maximize patient survival and post-treatment quality of life is yet unclear. Only some prognostic factors for HNC are relatively well understood, whereas others are affected by conflicting results of their significance. AIMS: The present study will explore and attempt to clarify the prognostic factors affecting HNC patients, focusing specifically on patients aged 80 or older. METHODS: A database of HNC patients treated at our center between 2006 and 2011 was generated in Mosaiq (an electronic patient record system); from this, a sample of patients aged 80 or older was selected randomly (n = 40). Various disease-, patient-, and treatment-related factors were collected from these records and compared against the patients' overall survival, disease-free status, rates of recurrence, and rates of radiation toxicity to determine which were significant prognostic indicators. CONCLUSIONS: Disease subsite was found to be a significant indicator of local recurrence (P = .049) and survival rate (P = .014), while anemia was related to poor disease-free status on follow-up (P = .017). Age was not significantly linked to any outcome measure. However, patients treated with palliative intent were significantly older (P = .012) despite not having higher stage disease, and only one radical patient (3.2%) failed to complete their treatment course. Follow-up data, quantitative toxicity data, and human papillomavirus and smoking status were either inconsistently collected or unavailable, identifying areas for improvement to better inform evidence-based practice.