Reflective Template:  Quality Improvement Activity (QIA)

This reflective template has been designed to use with SOAR (Scottish Online Appraisal Resource).  On completion, please upload this to SOAR for submitting to your appraisal to share with your appraiser.	3-step guide to completing this form:

1)	Save this form (using “Save As”) to your computer (e.g. My Documents, Desk top), and rename the file (e.g. QIA Reflection 2021)
2)	Proceed to filling out the form - when finished, Save and Close the document.
3)	Login to SOAR and Upload this file from where you had saved it (from step 1) to your current appraisal.	

The boxes will expand automatically as you type into them.
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[This example was first submitted in 2013.]

What supporting information have you provided for your QIA?
Protocol for prostate and pelvic IMRT for pelvic node positive prostate cancer patients, which has been implemented.	

What strengths or achievements does it demonstrate?
This was a new development to treat patients with prostate cancer who were pelvic node positive on staging investigations, to treat them using IMRT/VMAT. This has been successfully implemented after a pilot phase.

This clearly shows learning from others as the support was seen from team in Marsden to develop this service for our patients.

This also shows the importance of team working and using skills and experiences of others for better patient care and outcomes.	

Did you encounter any difficulties in this process?
This was a very time consuming process, and planning a single case took about 2 hours at the start but this has improved since we have successfully completed the pilot phase.

Multiple meetings with physics and with team members to convince them that this effort was in best interest of patients.	

Have you been able to make any changes as a result of undertaking this activity?
This protocol is now implemented to treat all fit pelvic node positive patients and is routinely used, and the toxicity is much less compared with the old conformal non-IMRT RT.

We will be working to escalate dose and to consider high-risk node-positive patients in the future.

What have you learned from undertaking this activity?

Is there anything else that you would like to/ need to do to follow it up?
We will collect the toxicity data and PSA relapse data to help to show that this treatment offers less toxicity and better PSA control and Quality of Life.