CT Simulation Optimization at King Hussein Cancer Center
April 2025
CT Simulation Optimization
at King Hussein Cancer Center
Radiotherapy Unit
King Hussein Cancer Center
Amman
Jordan
Shatha Elayan, RN
Fadwa Abdelrahman, MD
Wafa Asha, MD
Aseel Aljundi, RN
Mohammad AlAzzeh, Radiotherapy Technologist
Nidal Al-Horani, Radiotherapy Technologist
Ahlam Al Zouby, RN
Hebah ALSarahin, RN
Marwa Kashouqa, RN
Fadwa Abdelrahman, MD
Wafa Asha, MD
Aseel Aljundi, RN
Mohammad AlAzzeh, Radiotherapy Technologist
Nidal Al-Horani, Radiotherapy Technologist
Ahlam Al Zouby, RN
Hebah ALSarahin, RN
Marwa Kashouqa, RN
Optimizing CT Simulation for Cancer Patients Undergoing Breast and Pelvic Radiotherapy: An Interprofessional QI Project
CT simulation is an essential component of the treatment planning for patients receiving radiotherapy in oncology settings. At the King Hussein Cancer Center (KHCC), every patient scheduled for radiation therapy undergoes a CT simulation to accurately map the treatment area and ensure precise delivery of radiation.
Clinical Nurse Coordinators in the Radiotherapy Unit at KHCC play a key role in this process. They ensure the timely scheduling of CT simulations and treatment sessions, coordinate patient care, facilitate communication among multidisciplinary team members, and provide ongoing support to patients and their families throughout the radiotherapy journey—ultimately optimizing clinical outcomes, ensuring patient safety, and enhancing the overall patient experience.
This inspiring story began with one of our dedicated Clinical Nurse Coordinators, Shatha Elayan, RN, in the Radiotherapy Unit, who consistently advocates for her patients with empathy. She noticed that one of her patients, diagnosed with breast cancer, was required to undergo a repeat CT simulation—an issue that not only extended the patient’s treatment journey but also raised safety concerns. This resulted in additional visits to the radiotherapy unit, increased radiation exposure, and reduced patient satisfaction.
As a result, reducing CT re-simulations for patients undergoing radiotherapy for breast or pelvic cancers was identified as a key area for improvement. In response, the radiotherapy nursing team launched an interprofessional quality improvement project in 2024 to address this issue and promote high-quality, safe care while enhancing the overall patient experience.
This project aimed to enhance patient care by achieving a 50% reduction in preventable re-CT simulations among cancer patients undergoing breast and pelvic radiotherapy. A dedicated interprofessional team was formed, led by Clinical Nurse Shatha, and included nurses, radiation oncologists, and radiotherapy technologists. The team identified key performance indicators (KPIs) to measure the project's impact. These included a reduction in re-CT simulation rates, improved patient satisfaction, and a decrease in the financial loss caused by repeated imaging procedures.
Interprofessional collaboration was a cornerstone of the project’s success. Nurses in the Radiotherapy Unit worked closely with other team members to share their knowledge and expertise, align project goals, and co-develop practical interventions. By combining their diverse professional expertise, the team ensured that every action taken was safe, coordinated, and tailored to meet patient needs. This strong teamwork played a crucial role in achieving the project’s outcomes and enhancing the quality of care delivered.
The project team adopted the FOCUS–PDCA quality improvement methodology to guide their efforts. They began by reviewing the current CT simulation process for cancer patients undergoing breast and pelvic radiotherapy and collecting relevant data. A comprehensive cause-and-effect analysis was conducted to identify the factors contributing to the need for re-CT simulations. The findings revealed two categories: preventable and non-preventable factors, with preventable factors accounting for 57% of the causes. The team chose to focus on these preventable factors and, based on their analysis, implemented a set of tailored, high-impact interventions to address them.
The project interventions were designed to improve both the accuracy of CT simulations and the overall patient experience. For breast cancer patients, ensuring full range of motion during CT simulation and introducing hand grips helped reduce motion artifacts, enhancing image quality and patient comfort. For those undergoing pelvic radiotherapy, the team implemented bowel preparation protocols and used bladder-filling verification with Clarity ultrasound to ensure optimal simulation conditions. These compassionate and carefully planned actions set the foundation for the project’s meaningful outcomes—improving efficiency, reducing the stress and discomfort of repeated visits, and strengthening patient safety by minimizing the need for unnecessary radiation exposure.
Following the successful implementation of the project, the outcomes were both significant and inspiring. The rate of preventable CT re-simulations among breast and pelvic radiotherapy patients dropped dramatically, from 57% in the pre-intervention period to just 9% post-intervention. This significant reduction enhanced patient safety by minimizing unnecessary radiation exposure and emotional stress, while also improving the use of time, staff, and imaging resources, enabling more patients to be served efficiently. Moreover, it significantly reduced the financial loss associated with repeated CT simulations. Most importantly, these efforts led to a noticeable improvement in overall patient satisfaction, demonstrating the team’s deep commitment to delivering safe, efficient, and compassionate care.
This dedicated interprofessional team has demonstrated a remarkable commitment to improving patient care. By significantly reducing preventable re-CT simulations, enhancing patient satisfaction, and minimizing financial losses, the team has optimized the radiotherapy experience for patients undergoing breast and pelvic treatment. Their efforts reflect not only clinical excellence but also a deep respect for the comfort, safety, and dignity of every patient, making their achievement truly exemplary.
CT simulation is an essential component of the treatment planning for patients receiving radiotherapy in oncology settings. At the King Hussein Cancer Center (KHCC), every patient scheduled for radiation therapy undergoes a CT simulation to accurately map the treatment area and ensure precise delivery of radiation.
Clinical Nurse Coordinators in the Radiotherapy Unit at KHCC play a key role in this process. They ensure the timely scheduling of CT simulations and treatment sessions, coordinate patient care, facilitate communication among multidisciplinary team members, and provide ongoing support to patients and their families throughout the radiotherapy journey—ultimately optimizing clinical outcomes, ensuring patient safety, and enhancing the overall patient experience.
This inspiring story began with one of our dedicated Clinical Nurse Coordinators, Shatha Elayan, RN, in the Radiotherapy Unit, who consistently advocates for her patients with empathy. She noticed that one of her patients, diagnosed with breast cancer, was required to undergo a repeat CT simulation—an issue that not only extended the patient’s treatment journey but also raised safety concerns. This resulted in additional visits to the radiotherapy unit, increased radiation exposure, and reduced patient satisfaction.
As a result, reducing CT re-simulations for patients undergoing radiotherapy for breast or pelvic cancers was identified as a key area for improvement. In response, the radiotherapy nursing team launched an interprofessional quality improvement project in 2024 to address this issue and promote high-quality, safe care while enhancing the overall patient experience.
This project aimed to enhance patient care by achieving a 50% reduction in preventable re-CT simulations among cancer patients undergoing breast and pelvic radiotherapy. A dedicated interprofessional team was formed, led by Clinical Nurse Shatha, and included nurses, radiation oncologists, and radiotherapy technologists. The team identified key performance indicators (KPIs) to measure the project's impact. These included a reduction in re-CT simulation rates, improved patient satisfaction, and a decrease in the financial loss caused by repeated imaging procedures.
Interprofessional collaboration was a cornerstone of the project’s success. Nurses in the Radiotherapy Unit worked closely with other team members to share their knowledge and expertise, align project goals, and co-develop practical interventions. By combining their diverse professional expertise, the team ensured that every action taken was safe, coordinated, and tailored to meet patient needs. This strong teamwork played a crucial role in achieving the project’s outcomes and enhancing the quality of care delivered.
The project team adopted the FOCUS–PDCA quality improvement methodology to guide their efforts. They began by reviewing the current CT simulation process for cancer patients undergoing breast and pelvic radiotherapy and collecting relevant data. A comprehensive cause-and-effect analysis was conducted to identify the factors contributing to the need for re-CT simulations. The findings revealed two categories: preventable and non-preventable factors, with preventable factors accounting for 57% of the causes. The team chose to focus on these preventable factors and, based on their analysis, implemented a set of tailored, high-impact interventions to address them.
The project interventions were designed to improve both the accuracy of CT simulations and the overall patient experience. For breast cancer patients, ensuring full range of motion during CT simulation and introducing hand grips helped reduce motion artifacts, enhancing image quality and patient comfort. For those undergoing pelvic radiotherapy, the team implemented bowel preparation protocols and used bladder-filling verification with Clarity ultrasound to ensure optimal simulation conditions. These compassionate and carefully planned actions set the foundation for the project’s meaningful outcomes—improving efficiency, reducing the stress and discomfort of repeated visits, and strengthening patient safety by minimizing the need for unnecessary radiation exposure.
Following the successful implementation of the project, the outcomes were both significant and inspiring. The rate of preventable CT re-simulations among breast and pelvic radiotherapy patients dropped dramatically, from 57% in the pre-intervention period to just 9% post-intervention. This significant reduction enhanced patient safety by minimizing unnecessary radiation exposure and emotional stress, while also improving the use of time, staff, and imaging resources, enabling more patients to be served efficiently. Moreover, it significantly reduced the financial loss associated with repeated CT simulations. Most importantly, these efforts led to a noticeable improvement in overall patient satisfaction, demonstrating the team’s deep commitment to delivering safe, efficient, and compassionate care.
This dedicated interprofessional team has demonstrated a remarkable commitment to improving patient care. By significantly reducing preventable re-CT simulations, enhancing patient satisfaction, and minimizing financial losses, the team has optimized the radiotherapy experience for patients undergoing breast and pelvic treatment. Their efforts reflect not only clinical excellence but also a deep respect for the comfort, safety, and dignity of every patient, making their achievement truly exemplary.