Purpose This study reports on the implementation of an electronic consent-to-treatment system (e-Consent) in a busy radiation medicine program and compares it with the previous paper-based method of documenting patient consent. Methods A password-protected, electronic, e-Consent application was designed in-house and installed on iPad devices to document patient consent for radiation therapy treatments. A feasibility study, followed by a program-wide deployment of e-Consent, was executed. The effectiveness and impact of e-Consent on workflow were determined by comparing the number of problems arising from the paper-based consenting method with those from the e-Consent process. Staff satisfaction and perceived impact of e-Consent on workflow were determined by a program-wide survey of e-Consent users. Results The e-Consent completion rate was 94.2% (5,600 of 5,943 forms) 1 year after implementation, indicating successful uptake at the program level. Although the paper-based method of documenting patient consent was associated with an error rate of 7% (24 of 343 forms), e-Consent was associated with an error rate of 0.32% (18 of 5,600 forms) 1 year after deployment. Results of a 10-item e-Consent user survey indicated improvement in staff workflow and high overall satisfaction with e-Consent. Conclusion e-Consent is more efficient than paper-based methods for documenting patient consent. Moreover, replacing paper-based consent methods with an electronic version facilitated an improved workflow and staff satisfaction. Efforts aimed at implementing e-Consent throughout the entire cancer program are currently underway.

to be the biggest barrier. Other barriers included lack of time to complete the assessments. Positive clinician attitudes was the biggest facilitator identified. Interventions were selected to target the barriers and optimize use of facilitators. Educational sessions targeted the barrier of lack of awareness and knowledge. A local opinion leader will be recruited to mentor others. Knowledge use will be monitored using pre & post questionnaires, clinical observations, and chart reviews. Three primary outcomes will be evaluated after 6 months: patient satisfaction, changes in patient fatigue scores, and RTT awareness, knowledge and attitudes about the CCO SMG. As the last framework step, knowledge use will be sustained through monitoring with standard chart reviews. Successes will be celebrated and results shared at staff meetings. Benefits/Challenges: KT frameworks can increase the success of implementing and sustaining a change in practice. This framework incorporates critical elements of change and targets areas that often lead to failure. The strategy can be built into our current processes which also facilitates increased adoption. One of the challenges to using this framework was evaluating and sustaining the change. In addition, this strategy targets front-line MRT(T)s only and does not involve other stakeholders. It does not impact changes that may be needed at the organizational level. For example, more time may be needed for patient appointments to follow the guidelines. Impact: A knowledge translation strategy was developed to address an evidence-to-practice gap in the screening, assessment and management of CRF by MRT(T)s. Utilizing this strategy to close this gap is anticipated to improve care, patient satisfaction and quality of life for our patients.

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