Implementing results of a change process at the Andrew Love Cancer Centre - the axillary technique

Purpose: Change is ever present in radiation therapy departments and it can impact on the quality of work, staffing and job satisfaction. Understanding stages of change for individuals can assist management in successfully developing the service of their department. At the Andrew Love Cancer Centre (ALCC) there have been many developments in recent years. This paper aims to describe a successful change in practice at the ALCC, focusing on the quality assurance improvements made with the introduction of a new radiotherapy treatment technique used for melanoma, squamous cell carcinoma and Merkel cell carcinoma with axillary node involvement. Methods: A four-stage model of change was used to guide the introduction of the new axillary technique. Th e accuracy of the new technique was evaluated in comparison with the historical technique, using pre-treatment images. Results: A total of 219 pre-treatment images were analysed in this study, 141 with the historical technique and 78 with the new. Seven out of eight reference points indicated reductions in translational correction in field placement with the new technique compared to the historical. Conclusion: Improvements in set-up accuracy were found when utilising the new set-up technique compared with the historical technique. Th e four-stage model of change assisted in the smooth implementation of this new treatment technique. At the ALCC innovation and development are encouraged, along with management having a sound understanding of organisational change enabling the radiation therapy department to develop successfully and cope with rapid change.