The aim of this project was to improve the quality of the delivery of care
to patients undergoing outpatient fractionated radiotherapy, in terms of ef
fectiveness and efficiency. This article provides a descriptive account of
the activities that took place within a traditional doctor-held radiotherap
y review (floor) clinic (71 individual clinic episodes from 71 patients) an
d compares them with a nurse-led clinic (299 clinic episodes from 141 patie
nts). The outcome measures encompassed the number and type of activities in
both clinics, including the number of interventions that occurred, consult
ation time, waiting time, degree of involvement with other support services
, reasons for doctor contact, and perceptions of patients, doctors, nurses
and therapy radiographers.
Nurse consultations lasted longer than doctor consultations. Waiting times
were reduced. Of 299 nurse-led clinic episodes, only 21 contacts were made
with the doctor. More interactions and activities occurred during nurse con
sultations. A greater number of referrals and liaisons with other support s
ervices occulted, resulting in the establishment of continuity of care.
The results from this small sequential observational study require prospect
ive confirmation, but they suggest that specialist nursing staff, given app
ropriate medical support, may provide more effective care for patients who
are undergoing outpatient radiotherapy.