Increased Efficiency and Reduced Re-Positioning of Patients Through SGRT

Noelle Ziegelbauer,
MHA, RT(T) (ARRT) Manager of Radiation Oncology, SSM Health St. Mary’s Hospital
Janesville Stephanie Hoff,
BS, RT(T) (ARRT)
Lead Radiation Therapist,
SSM Health St. Mary’s Hospital-Janesville

2. Reducing Re-Positioning of
Patients Through the
Utilization of SGRT

3. Agenda
1.Who We Are
2.Benefits of SGRT
3.Advantages of Consistent Staff Training and ROI Drawing
4.Increasing Patient Satisfaction
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

4. Who We Are
SSM Health St. Mary’s Hospital-Janesville
June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT

5. SSM Health St. Mary’s Hospital-Janesville
Catholic, not-for profit health system
•Headquarters in St. Louis
•Illinois, Missouri, Oklahoma, and Wisconsin
Location: Janesville, WI
Population: 66,202
Community Hospital
•Offering acute inpatient services and
outpatientcare
•50-bed
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

6. SSM Health St. Mary’s Hospital-Janesville
Radiation Oncology
1 of 3 Radiation Oncology Departments in
RockCounty
First Patient treated August 15, 2016
Technology
•VarianTrueBeamLinear Accelerator
•Dedicated GE CT Simulator
•AlignRTCamera System
Center of Excellence forAlignRT, 2020
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

7. SSM Health St. Mary’s Hospital-
JanesvilleRadiation Oncology
Department Averages
•Annual Consults: 167
•Annual Simulations: 151
•Average Daily Treatments: 12
Staffing
•1 Radiation Oncologist
•1 Physicist
•3- 1.0 FTE Radiation Therapists
•2- 0.5 FTE RNs
•1- Unit Assistant
•1- Manager
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

8. Benefits of SGRT
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

9. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
More accurate patient set-ups
Faster Patient set-ups
Simplifies patient set ups
§Extremities
§Electron
§Abutting Fields
§Prone Breast
Benefits of SGRT
Shorter treatment scheduling duration
Improved RTT satisfaction
Improved Patient satisfaction
Minimizes re-imaging of patients

10. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Reimaging data: All Treatment Sites—Mv/KV &
CBCT
2018: Utilizing Tattoos
•Patients with daily imaging:
120
•Total number of images:
3,343
•Total number of re-images:
158
•Re-images per patient:
1.32
2021: Tattoo-Free
•Patients with daily imaging:
132
•Total number of images:
3,469
•Total number of re-images:
111
•Re-images per patient:
0.82
2022-2023 Tattoo-Free
•Patients with daily imaging:
285
•Total number of images:
3,566
•Total number of re-images:
75
•Re-images per patient:
0.26

11. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Reimaging Data: Breast/Sclav/Ax/CW
2018: Utilizing Tattoos
•Patients with daily imaging:
37
•Total number of images:
1,142
•Total number of re-images:
31
•Re-images per patient:
.84
2021:Tattoo-Free
•Patients with daily imaging:
37
•Total number of images:
1,134
•Total number of re-images:
9
•Re-images per patient:
0.24
2022-2023: Tattoo-Free
•Patients with daily imaging:
62
•Total number of images:
1,093
•Total number of re-images:
4
•Re-images per patient:
0.06

12. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Reimaging Data: Brain and H&N
2018: Utilizing Marks on Masks
•Patients with daily imaging:
19
•Total number of images:
492
•Total number of re-images:
33
•Re-images per patient:
1.74
2021: Tattoo-Free & Open Face
Masks
•Patients with daily imaging:
16
•Total number of images:
403
•Total number of re-images:
6
•Re-images per patient:
0.38
2022-2023: Tattoo-Free & Open
Face Masks
•Patients with daily imaging:
44
•Total number of images:
500
•Total number of re-images:
7
•Re-images per patient:
0.16

13. Advantages of Consistent Staff
Training and ROI Drawing
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

14. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Staff training and Buy-in
Training
•ROI drawing
•Understanding processes
•Understanding how to utilize the equipment
•Importance of trusting postural alignment
•Fine tuning setups
•Eliminating the “close enough” mentality
•Staffing changes
Showing Proof/Data collected

15. Pelvis ROI Then vs. Now
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

16. Breast ROI Then vs. Now
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

17. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Head and Neck ROI

18. Increasing Patient Satisfaction
Reducing Re-Positioning of Patients Through the Utilization of SGRTJune 7, 2024

19. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Patient Experience Survey Results
Increased Patient Satisfaction by:
•No permanent marks
•Quicker set-ups
•Shorter treatment time slots
•Increased patient confidence in treatment
accuracy through technology

20. Patient Comments
“I am so happy that I do not have to
have tattoos. At my age it is not
something I ever thought about having
and I would rather not have anything
done that is not 100% necessary.”
-Satisfied Patient A
“Prior to starting radiation, I had heard about
the tattoos. It gave me a lot of anxiety. I
thought to myself haven’t I already been
through enough. Tattoos would be another
permanent reminder of what I am going
through. When I came to SSM St. Mary’s-
Janesville and found out I didn’t need to have
tattoos I was so relieved.”
-Satisfied Patient B

21. June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT
Caregiver Testimonial
“It’s a good thing that she didn’t have to have tattoos because she would be afraid
peers would see it during swimming and other activities. It gave us relief when we knew
they wouldn’t be there. She became accustom to the lights and it gave me comfort
knowing that it helped guide her setup to the correct area and monitored for
movement. It helped how everyone was so willing to explain to her. We are just so
grateful for the care we received. With her extra needs, this really helped get her
through it.”
-Satisfied Caregiver

22. Thank You to Our Team Past
and Present
Physician: Rick Auchter
Physicist: Todd Meyers
Radiation Therapists: Danielle
Elmer, Rileigh Clark,
Miranda Pernaski, &
Lacey Hermann
Nurses: Jenny McMullen &
Marilyn Mullikin
Unit Assistant: Nohemi
Palenske
Other Organizational
Leadership: Kim Schram, Eric
Thornton, & Kayla Murphy

23. Questions?
June 7, 2024Reducing Re-Positioning of Patients Through the Utilization of SGRT

24. Stephanie Hoff
Lead Radiation Therapist, Radiation
Oncology, St. Mary’s Hospital-Janesville
[email protected]
Noelle Ziegelbauer
Manager, Radiation Oncology, St. Mary’s
Hospital-Janesville
[email protected]
Thank You