My Working Day: Michelle Atkinson describes how a cancer audit project she manages is making a difference at Tallaght hospital
I manage a cancer audit project at Tallaght hospital that tracks the treatment of patients suffering from cancer in the hospital.
The cancer audit project aims to track patients' diagnosis, the surgical, medical and radiological treatments they receive, and the outcomes of these treatments. With this data we will be able to assess our cancer service and compare it to best practice. The aim is to ensure the hospital provides a quality cancer service to patients.
By being able to analyse data, we can revise protocols, improve the management of patients and improve outcomes.
Breast cancer patients were the first patients to be tracked when the project began in 2004. Since then, we have rolled it out on a phased basis to colorectal, urology, upper gastro and intestinal, lung and hepatopancreaticobiliary cancers.
The haematological malignancy register will be operational later this year. We have also computerised a clinic in the hospital - the rapid diagnostic breast clinic - which sees patients with suspected breast cancer referred by their GPs.
A big part of my job is training data managers in the use of the systems. They in turn have to train the multidisciplinary teams treating the patients how to input the data.
For example, surgeons immediately after surgery input the surgical data relating to the patient. We have computers in the corridor just outside theatre and they do it while they are in their scrubs. Similarly, just after multidisciplinary meetings decide on, say, the treatment of breast cancer patients, doctors attending the meeting will input the relevant data.
This system allows quick and easy audits of our cancer services. Prior to this, for an audit to take place, the charts of 1,000 patients had to be pulled out. Now we can compare our services to other hospitals and to best-practice benchmarks easily.
The system also allows quality assurance checks. Every three to four months we pull out 10 per cent of our patients' charts and compare them to the data we have on the system to ensure the data is complete and accurate.
There are many benefits. Because a doctor enters the data, it is accurate.
Otherwise, it would be a case of someone else trying to interpret an operative note written by a clinician, and it would not necessarily have been accurate. In addition, with such a system, the information may be input three to four weeks after the procedure.
The key to a system such as this is having the consultants on board. It is very difficult if they are not. Since the Drogheda case, quality assurance has become a big issue. Consultants have realised the importance of auditing their management of patients. It is also very useful for service planning and service management.
Once clinicians saw the success of the breast cancer audit project, and witnessed the ability to produce audits so easily and so quickly, they were very keen.
I have a nursing background, but went on to study business studies and information technology. I now spend most of my time in front of a computer. I liaise regularly with the cancer multidisciplinary teams and the database managers.
Because it is a new service, the work has been quite challenging. But I'm happy that it has been so successful and that it is being rolled out to new areas.
(In conversation with Fiona Tyrell)