1. The Application A3 Thinking: Bladder VMAT Radiotherapy Technique Implementation
Michael Trainer, Principal Clinical Scientist, Radiotherapy Physics, The Christie NHS Foundation Trust
Problem Statement: “Current treatment technique will not be supported by new treatment machines.”
Older technique (shown below) requires wedges to modulate the intensity of the beams to account for the patient’s shape
wedges
Dose Distribution
A technique called VMAT which creates one constantly modulated field which arcs around the patient was implemented. This technique provides superior dose sparing for healthy tissues and is more efficient to deliver
VMAT Technique
4-Field Brick Technique
Practical measurements were carried out on Phantoms to test our modelling of the complex dose distribution of the VMAT technique before clinical implementation.
Project carried out as part of “Leading Transformational and Cultural Change” Course:
Participated in an Action Learning Set with a small group of peers
A3 process introduced and developed throughout project
Support from class based teaching, discussion and external coaching
Applied alongside a series of other leadership concepts introduced on the course
Visits to Royal Bolton Laboratories and Jaguar Landrover to see how LEAN processes had been introduced successfully
Conclusions:
A3 process: helped me to see projects I am leading as being more fluid rather than having their direction set – eg. regular current state analysis and re-evaluation.
Not all parts of A3 process are suitable for all projects – it is important to identify this at the time.
Clearly defining the problem before starting on a project will help the project move forward quicker
For all projects in future I will now “Start with the end in mind”(S.Covey The 7 Habits of Highly Effective People), which is a concept that has helped me plan my work based projects in a different way
I found the support from my Action Learning Set extremely beneficial to both my project and my Leadership development and will look to develop this further