Managing TG-51 reference dosimetry in a large hospital network can be a challenging task. The objectives of this study are to investigate the effectiveness of using Statistical Process Control (SPC) to manage TG-51 wo...Managing TG-51 reference dosimetry in a large hospital network can be a challenging task. The objectives of this study are to investigate the effectiveness of using Statistical Process Control (SPC) to manage TG-51 workflow in such a network. All the sites in the network performed the annual reference dosimetry in water according to TG-51. These data were used to cross-calibrate the same ion chambers in plastic phantoms for monthly QA output measurements. An energy-specific dimensionless beam quality cross-calibration factor, <img src="Edit_6bfb9907-c034-4197-97a7-e8337a7fc21a.png" width="20" height="19" alt="" />, was derived to monitor the process across multiple sites. The SPC analysis was then performed to obtain the mean, <img src="Edit_c630a2dd-f714-4042-a46e-da0ca863cb41.png" width="30" height="20" alt="" /> , standard deviation, <span style="font-size:6.5pt;font-family:;" "=""><span style="white-space:normal;"><span style="font-size:6.5pt;font-family:"">σ</span><span style="white-space:nowrap;"><sub><i>k</i></sub></span></span></span>, the Upper Control Limit (UCL) and Lower Control Limit (LCL) in each beam. This process was first applied to 15 years of historical data at the main campus to assess the effectiveness of the process. A two-year prospective study including all 30 linear accelerators spread over the main campus and seven satellites in the network followed. The ranges of the control limits (±3σ) were found to be in the range of 1.7% - 2.6% and 3.3% - 4.2% for the main campus and the satellite sites respectively. The wider range in the satellite sites was attributed to variations in the workflow. Standardization of workflow was also found to be effective in narrowing the control limits. The SPC is effective in identifying variations in the workflow and was shown to be an effective tool in managing large network reference dosimetry.展开更多
Objective:To understand the healthcare needs of disabled oncology patients,explore the impact of home network hospital-based health education on disabled oncology patients’healthcare needs,activity of daily living(AD...Objective:To understand the healthcare needs of disabled oncology patients,explore the impact of home network hospital-based health education on disabled oncology patients’healthcare needs,activity of daily living(ADL)scores,quality of survival,and caregiver burden,and to provide a reference basis for the effective implementation of health education for disabled oncology patients in the home and the improvement of their quality of life.Methods:From May 2021 to May 2024,112 patients with ADL Scale scores<60 who were hospitalized in 7 tertiary-level hospitals in Guangdong Province were selected for the questionnaire survey and implementation of the intervention analysis.The 112 study subjects chosen were randomly divided into 56 in the intervention group and 56 in the control group.The patients in the control group were discharged from the hospital and followed up once a month by telephone,health education,and disease rehabilitation guidance.The intervention group constructed a home network hospital on a routine basis,utilized the micro letter public number and APP applet intervention guidance for 6 consecutive months,and used the general information questionnaire,Barthel index,SF-36 quality of life scale(the Medical Outcomes Study item short-form health survey,SF-36),the caregiver’s quality of life scale(the SF-36),and the Caregiver Burden Scale ZBL(Zarit Burden Interview,ZBI),to investigate the number of care needs,quality of life,and the degree of caregiving burden of the 2 groups of patients.Results:The quality of survival of all patients with disabling tumors was poor.Patients with moderate to severe dependence on ADL were not only impaired in physiological dimensions but also had varying degrees of reduction in psychological dimensions,with the lowest scores in physiological functioning and the highest scores in somatic pain.There was no statistically significant difference in the comparison of the general information and scores of patients in the 2 groups(P>0.05).After 3 months and 6 months of intervention,the difference in scores between the 2 groups was statistically significant(P<0.05),in which the SF-36 score of the intervention group was higher than that of the control group,and the ADL score was lower than that of the control group.There was a statistically significant difference in ADL and ZBI scores between the intervention and pre-intervention(P<0.05)groups.In the control group,after 3 months of intervention,ADL and ZBI scores were statistically different compared with pre-intervention(P<0.05);after 6 months of intervention,there was no statistical difference(P>0.05).Conclusions:Health education based on home network hospitals can reduce the healthcare needs of disabled oncology patients and meet their safety and physiological health guidance needs.The quality of life of disabled oncology patients is at the bottom level,the burden of family care is heavy,and the burden of care for the primary caregiver is heavy.At the root of the problem,there is a lack of scientific,effective,and practical interventions,which can be sorted by clarifying the patients’needs for home care and providing targeted nursing skills can improve the quality of life of the patients and reduce somatic discomfort.展开更多
文摘Managing TG-51 reference dosimetry in a large hospital network can be a challenging task. The objectives of this study are to investigate the effectiveness of using Statistical Process Control (SPC) to manage TG-51 workflow in such a network. All the sites in the network performed the annual reference dosimetry in water according to TG-51. These data were used to cross-calibrate the same ion chambers in plastic phantoms for monthly QA output measurements. An energy-specific dimensionless beam quality cross-calibration factor, <img src="Edit_6bfb9907-c034-4197-97a7-e8337a7fc21a.png" width="20" height="19" alt="" />, was derived to monitor the process across multiple sites. The SPC analysis was then performed to obtain the mean, <img src="Edit_c630a2dd-f714-4042-a46e-da0ca863cb41.png" width="30" height="20" alt="" /> , standard deviation, <span style="font-size:6.5pt;font-family:;" "=""><span style="white-space:normal;"><span style="font-size:6.5pt;font-family:"">σ</span><span style="white-space:nowrap;"><sub><i>k</i></sub></span></span></span>, the Upper Control Limit (UCL) and Lower Control Limit (LCL) in each beam. This process was first applied to 15 years of historical data at the main campus to assess the effectiveness of the process. A two-year prospective study including all 30 linear accelerators spread over the main campus and seven satellites in the network followed. The ranges of the control limits (±3σ) were found to be in the range of 1.7% - 2.6% and 3.3% - 4.2% for the main campus and the satellite sites respectively. The wider range in the satellite sites was attributed to variations in the workflow. Standardization of workflow was also found to be effective in narrowing the control limits. The SPC is effective in identifying variations in the workflow and was shown to be an effective tool in managing large network reference dosimetry.
文摘Objective:To understand the healthcare needs of disabled oncology patients,explore the impact of home network hospital-based health education on disabled oncology patients’healthcare needs,activity of daily living(ADL)scores,quality of survival,and caregiver burden,and to provide a reference basis for the effective implementation of health education for disabled oncology patients in the home and the improvement of their quality of life.Methods:From May 2021 to May 2024,112 patients with ADL Scale scores<60 who were hospitalized in 7 tertiary-level hospitals in Guangdong Province were selected for the questionnaire survey and implementation of the intervention analysis.The 112 study subjects chosen were randomly divided into 56 in the intervention group and 56 in the control group.The patients in the control group were discharged from the hospital and followed up once a month by telephone,health education,and disease rehabilitation guidance.The intervention group constructed a home network hospital on a routine basis,utilized the micro letter public number and APP applet intervention guidance for 6 consecutive months,and used the general information questionnaire,Barthel index,SF-36 quality of life scale(the Medical Outcomes Study item short-form health survey,SF-36),the caregiver’s quality of life scale(the SF-36),and the Caregiver Burden Scale ZBL(Zarit Burden Interview,ZBI),to investigate the number of care needs,quality of life,and the degree of caregiving burden of the 2 groups of patients.Results:The quality of survival of all patients with disabling tumors was poor.Patients with moderate to severe dependence on ADL were not only impaired in physiological dimensions but also had varying degrees of reduction in psychological dimensions,with the lowest scores in physiological functioning and the highest scores in somatic pain.There was no statistically significant difference in the comparison of the general information and scores of patients in the 2 groups(P>0.05).After 3 months and 6 months of intervention,the difference in scores between the 2 groups was statistically significant(P<0.05),in which the SF-36 score of the intervention group was higher than that of the control group,and the ADL score was lower than that of the control group.There was a statistically significant difference in ADL and ZBI scores between the intervention and pre-intervention(P<0.05)groups.In the control group,after 3 months of intervention,ADL and ZBI scores were statistically different compared with pre-intervention(P<0.05);after 6 months of intervention,there was no statistical difference(P>0.05).Conclusions:Health education based on home network hospitals can reduce the healthcare needs of disabled oncology patients and meet their safety and physiological health guidance needs.The quality of life of disabled oncology patients is at the bottom level,the burden of family care is heavy,and the burden of care for the primary caregiver is heavy.At the root of the problem,there is a lack of scientific,effective,and practical interventions,which can be sorted by clarifying the patients’needs for home care and providing targeted nursing skills can improve the quality of life of the patients and reduce somatic discomfort.
