Chart Rounds At A High Volume Hospital Program: Quantifying Discussion Time As A Function Of Patient And Treatment Parameters

Chart Rounds represents an important quality assurance institution which focuses on physician and physicist peer review. Its use is ubiquitous in the field of radiation oncology and successful implementation is a requirement for accreditation by established governing bodies. Despite its importance, there is scant literature which identifies time spent on each chart review. This study provides an examination of time spent in this endeavor and explores factors that influence the length thereof at a busy hospital practice. In October, 2015, we employed an electronic medical record (EMR) with automated triggered events based on scheduling of patient treatment. Based on the initiation and completion of an event, a time stamp is generated in the EMR. We analyzed time stamps that focused on the initiation and completion of an event associated with the review of individual patient treatments at Chart Rounds. During these weekly meetings, review focuses on consultation notes, dose constraint sheets, prescriptions, treatment plans, and, when applicable, port film review. From January 8, 2016 to December 30, 2016 1199 consecutive patient charts were reviewed at weekly chart rounds. 83.3% of cases involved definitive treatment vs. 16.7% involving palliative radiation. 52.5% of reviewed cases involved the use of stereotactic techniques; 26.5%, 14.1%, and 5.7% involved 3DCRT, hand calculations (calcs), and IMRT, respectively. 127 (10.6%) of the presentations involved a subsequent treatment course for a previously reviewed patient. The mean time per patient presentation was 142.6 seconds (s). Discussions relating to 3DCRT (209.6s) and IMRT (204.5s) were longer on average than those involving Stereotactic treatment (104.2s) and hand calcs (136.8s; p