Collaborating on breast cancer radiotherapy in the region: experiences and lessons
Author: Gabriëlle Speijer
In recent years, radiotherapy teams have collaborated intensively on breast cancer to improve care for breast cancer at a regional level. We are happy to share our insights to inspire colleagues and offer practical tips. We also like to hear what we can still do better, because we are never “done”. However, we have taken valuable steps towards better care, while at the same time having a lot of fun in the collaboration!
Started simply and informally, out of need
Our collaboration arose, on the one hand, from the wish of radiation oncologists across the 3 locations to align medical protocols better with each other. On the other hand, from physicists and radiotherapy technologists who were going to set up the new planning system together. Through open conversations and searching for joint solutions, we have laid a foundation for improving the quality of care.
Bringing out the best in each other
Success came from mutual respect and the shared ambition to improve care. This required time and space for complex topics. The goal always remained central: better care for patients. That helped to discuss deadlines and disappointments with understanding for each other’s context and to prioritize again.
An example: a protocol adjustment was not implemented despite consultation. In a new conversation, this was revised, creating space for new agreements. By keeping each other sharp and light-hearted, a pleasant collaboration emerged—a powerful recipe for success!
Not just attending the meeting
In the beginning, there were naturally more consultation moments. Fortunately, these grew into active meetings with clear roles, responsibilities and timelines. Duplicate consultations made way for better prepared meetings, in which only relevant people and specific topics were involved. This increased efficiency and created more space in the agenda. It does require sharpness: knowing what you are responsible for and also what you are not! 😊
Harmonizing is not simply doing everything the same!
Collaborating often means striving for harmonization. We should explain that briefly. We distinguish between undesirable variations, such as differences in isodose lines, constraints or radiation schedules, and desirable variations, such as planning techniques or the AI implementation route. Through a phased approach with clear agreements, we eliminate undesirable variations by standardizing or harmonizing them and create space for learning together and innovating.
Although ambitious, this is achievable thanks to committed teams. Clinical physics plays a key role in identifying technical possibilities and adjusting them with an eye on the consequences. Many ideas, however, come from fellow radiotherapy technologists and technicians!
What were the challenges?
There were certainly challenges, such as the absence of colleague Marcelle, whose commitment remains unforgettable. This emphasizes that project-based support and setting priorities are essential. For collaboration, space is needed to do things differently or, on the contrary, not to do them. Therefore, map out what is truly necessary and feed the administrators the commonly stated goal and consequences. Why?
Future perspective
Because many challenges lie ahead of us, such as staff shortages, sustainability, incidents,… It is important to focus on what is possible. That means making very clear what we really have to do ourselves from our role in order to deliver care together (at top level).
This requires choices: doing things differently and organizing differently. It is also necessary to make full use of technological developments. Concretely, for our collaboration this means that we have reduced meetings somewhat, brought matters in and under at a national level within the national breast cancer platform of the NVRO, and that we as a group are focusing on sustainable employability and AI this year.
