Engendering Leadership and Fostering a Culture of Quality

Sustainability of a quality system

Even with a quality system in place, its adoption by the users is contingent on the quality system becoming part of the culture of the workplace. In radiation oncology, a nationally consistent approach to a quality culture, both from an informed expectation of the patients and the healthcare professionals, would encourage the adoption of a quality management system and adherence to the Radiation Oncology Practice Standards.

To ensure the ongoing sustainability of a quality system established under the Radiation Oncology Strategic Plan, the culture of quality should be fostered. Some organisations have identified several aspects which foster the required culture, which are:

• Identifying that all members of the radiation oncology community are in this together including jurisdictions, facilities, suppliers and patients;

• Understanding that there should be no subordinates or superiors allowed which inhibit free communication or democratic decision making;

• Valuing open and honest communication;

• Providing access to all information on all operations to everyone, within the limitations of privacy;

• Focusing on processes, which are constantly improved by evaluating outcomes and using evidence-based best practice;

• Recognising that both successes and failures are opportunities for learning.

These aspects need the investment of resources such as an information and communications system being able to be shared by all users. Establishing and promoting this culture of quality may be challenging given concerns for patient privacy and commercial interests between private and public practices. However, some elements may be implemented across Australia, while other elements supported and encouraged within a facility through incentivisation schemes or professional learning opportunities. This would include support for succession planning and networking for those individuals within a facility who are responsible for quality management. This leadership in quality management within radiation oncology should be developed and resourced throughout Australia to provide the means to sustain an on-going quality culture.

It has occurred in the past that centres would shut down services when change of management occurs. This can result in patients losing local access to treatment either part way through their treatment or for a period a time after diagnosis. These events should be managed in such a way for the continuity of service delivery to be met through appropriate service planning which may include transfer of patient referrals so that access to radiation oncology services are minimally disrupted. These events should be coordinated through the national strategic planning framework and will require collaboration of public and private providers possibly across jurisdictional boundaries.