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Michael Sherar, PHD President & CEO, Cancer Care Ontario: One of our burning platforms
for our work in improving health systems in Ontario is the rising incidence of cancer
in the province and this is largely driven by a growing and aging population.
Dr. Padraig Warde, Interim VP, Clinical Programs & Quality Initiatives; Provincial Head, Radiation
Treatment Cancer Care Ontario: The incidence of cancer is rising at the rate of 2.7 to
3% per year. So over the next 10 years alone we will have virtually a 30% increase in the
number of patients requiring radiation treatment.
Michael Sherar: If the needs just continue to go up and we do nothing we know that providers
will burn out.
Nicole Harnett, Project Lead, CSRT Projects: Around the turn of the century and into 2001
there was a grass roots organization of radiation therapists who had taken upon themselves to
investigate advanced practice in radiation therapy. We approached the Ministry of Health
with a proposal asking if they would fund us to conduct a feasibility study for whether
advanced practice in radiation therapy could prove to be a non-traditional and creative
solution to some of the problems that we had been cyclically experiencing here in Ontario.
Dr. Padraig Warde: We need to have a different model of how we deliver care. And one of the
aspects of that is the Clinical Specialist Radiation Therapist which can add another
layer in between the radiation therapist and the radiation oncologist.
Jeff Goodyear, Director, Ministry of Health and Long-term Care: The Clinical Specialist
Radiation Therapist is one the new roles that was put forward as part of the Health Force
Ontario, which is Ontario’s strategy to ensure that the population has access to the
kind of care it needs, the type of people it needs, the place it needs and when they
need it.
Nicole Harnett: The CSRT brings advanced knowledge skills and judgement to the existing inter-professional
radiation medicine team. And although CSRT positions differ from centre to centre all
focus on increasing capacity within the system, improving the quality of care delivered to
patients and in accelerating innovation in their area of specialization.
Krista McGrath, CSRT – Palliative Care, Carlo Fidani Peel Regional Cancer Centre:
By taking some of the responsibilities away from the doctors and even working in collaboration
with them it smoothed out some of the wrinkles in the process that were there before.
Dr. Padraig Warde: I think this is quite analogous to what has happened in nursing in the development
of advanced practice role, which has really improved the quality of care in nursing and
I expect the same to happen in radiation therapy.
Dr. *** Wells, Radiation Oncologists, Stronach Regional Cancer Centre: In the last few months
when we had our advanced practice therapists it’s been quite a revolution.
Marcia Smoke, Manager-Radiation Therapy, Juravinski Cancer Centre & Walker Family Cancer Centre:
There are very many benefits to the program and as a department manager it’s very exciting
to see some of these new projects come.
Julie Blain, CSRT- Palliative Care & Bone and Brain Sites, Juravinski Cancer Centre:
I would say my biggest success has been implementing change and consistency within the department.
I have a very good working relationship with therapists, with radiation oncologists so
I was able to easily demonstrate what could be done and what positive results could happen.
Grace Lee, CSRT-Breast Site, Princess Margaret Cancer Centre: I’m contributing as a CSRT
to delineate some of the targets for radiotherapy and also to help streamline the process.
Nicole Harnett: Of paramount importance to the Ministry of Health across all of the CSRT
projects was trying to ascertain if advanced practice in radiation therapy could decrease
wait times for the patients in Ontario.
Dr. Padraig Warde: The radiation oncologist can see an increased number of patients by
focusing on the task that only a radiation oncologist can do and these other tasks can
be taken on by a clinical specialist radiation therapist. All of our data shows that patients
are happier when these tasks are done because they are done in a more standardized fashion
which helps the patients get through their treatment more quickly.
Marcia Smoke: When you think about it what’s the most important thing? It’s to have the
care that the patient needs immediately. So having advanced practice therapists being
able to educate patients, talk to patients, talk about their toxicities at the time when
they need it has been really helpful to the patients.
Dr. *** Wells: Healthcare as we know it will transform changes in healthcare funding
in the very foreseeable future and so this is leverage for achieving that change.
Dr. Rob Dinniwell, Radiation Oncologists, Princess Margaret Cancer Centre: I could see
this position growing quite significantly, either improving the current provision of
care or just basically growing our ability to provide more care with fewer resources.
Amanda Bolderston, President, Canadian Association of Medical Radiation Technologists: We are
actually using the original competency profile developed by the CSRT project. We have rolled
that out nationally and we have validated it. So it is quite exciting to think that
we are using that as a national framework and hopefully in a few years different provinces
and different jurisdictions will be using that to develop their own CSRT roles.
Dr. *** Wells: We should do a lot more of this and rely on the folks trained in radiation
medicine, who get it, and rely a lot less on other allied professionals.
Michael Sherar: If we work in new and innovative ways together in collaborative teams in delivering
care we will not only be better able to meet the future needs of patients as a whole but
individual patient care will improve.
Dr. Padraig Warde: Because we are all focused on delivering quality care to patients.
For more information, please visit www.ontarioradiationtherapy.ca