Welcome To Radiation Oncology Queensland External beam radiation therapy does not make you radioactive, and it is perfectly safe for you to be with other people, including children, Welcome and thank you for choosing our practice. Radiation Oncology throughout your treatment. Queensland (ROQ) is committed to providing exceptional radiation therapy services to regional Queensland. ROQ believes in investing in the latest training and equipment to ensure it is able to deliver world-class treatment. The staff of ROQ are passionate about providing you, your family and carers with the highest quality service in a supportive and caring environment. We recognise all patients as individuals and aim to meet your specific needs by respecting your customs, spiritual beliefs, values and dignity. This booklet outlines general information regarding your radiation therapy treatment and what you need to bring, billing and privacy policies, as well as travel and accommodation information. What Is Radiation Therapy? ROQ uses External Beam Radiation (x-rays or electrons) to damage cancer cells whilst limiting the impact to healthy cells. It is a painless treatment similar to having an x-ray taken, that is localised and therefore The Staff At Radiation Oncology Queensland only causes symptoms in the area being treated. Radiation therapy treatment can be delivered on its own, or in conjunction with other forms The radiation oncology team consists of a combination of highly trained of treatment such as chemotherapy, hormones and surgery. medical professionals who work together to make sure you receive the Radiation therapy treatment is usually undertaken as an outpatient best care possible. This team includes: service and requires you to attend daily (Monday to Friday) over a • Radiation Oncologists number of days / weeks. Each course of radiation therapy is unique to • Radiation Therapists • Nurses • Administration Staff • Medical Physicists each person, as it is influenced by a number of factors. These factors include, but are not limited to: the site and stage of the disease, pathology of the disease, a person’s age and general health. • Allied Health staff – This includes Dieticians, Speech Pathologists, Radiation Therapy: Initial Consultation Physiotherapists, Occupational Therapists, Social workers and Psychologists. These services are provided by Queensland Health, Due to the complexity of information given about possible treatment options and are available to our patients. and the nature of your treatment (if applicable), we would recommend that a family member, friend or carer accompany you to the initial consult. Radiation Therapy: An Overview INITIAL CONSULTATION APPOINTMENT Radiation therapy is a complex treatment that requires a number of appointments. Below is a flow chart of the appointments you will have DATE_ _________________________________________ during your treatment. TIME __________________________________________ INITIAL CONSULTATION What to bring: RADIATION THERAPY PLANNING Bring this booklet COMPLETED ‘Registration forms’ that accompany this booklet. Current Medicare card and/or DVA card, Concession card and your Private Health Insurance card (if applicable). RADIATION THERAPY TREATMENT A VALID letter of referral from your referring practitioner. It is your responsibility to ensure your referral is valid at all times. Validity of your referral is 12 months for GPs and 3 months for specialists. An invalid referral means Medicare rebates will not be paid, making your treatment more expensive. FOLLOW UP Details of current medication including names, doses and frequency. Your GP or pharmacist can provide this for you. All x-rays, CTs, MRIs, bone and other radiological or nuclear Once you have completed your initial consultation with your Radiation medicine scans. Please also bring any reports you have obtained Oncologist, you will proceed to an appointment with our Account during the investigation of your medical condition. Administrator who will prepare an ‘Estimation of Fees’ for you. Pathology reports – blood tests and histopathology. Your referring A digital face photograph will be taken at this point so we can attach it to doctor may send these directly to us or give them to you to deliver. your medical record for identification purposes. Radiation Therapy: Planning What To Do When You Arrive Upon arrival, please report PLANNING APPOINTMENT to our administration desk. Our administration staff will register your details into DATE_ _________________________________________ our system ready for your initial consultation with your assigned Radiation Oncologist. TIME __________________________________________ As ROQ is a private facility there will be a charge for your initial consultation and payment is required at the time of consultation. At the initial consultation, your Radiation Oncologist will discuss your What to bring: radiation therapy treatment options with you. This will include a Bring this booklet, so we can document your radiation therapy discussion about your disease, the possible benefits and side effects of treatment start date and time. treatment and what radiation therapy entails. Your Oncologist is there to assist you, so please ask as many questions as necessary for you to make an informed decision. It may be helpful to bring someone along to this appointment, as well as a diary or notebook to record information and/or questions that you may have relating to your treatment. If you decide to proceed with a course of radiation therapy, you will be required to complete and sign a consent form. Signing this consent form indicates that you understand the benefits and side effects of having radiation therapy, and are willing to undertake radiation therapy treatment within our facility. All x-rays, CTs, MRIs, bone and other radiological or nuclear medicine scans. Please also bring any reports you have obtained during the investigation of your medical condition. Radiation therapy planning is the first step to creating an individualised treatment plan, and is necessary to accurately determine the most appropriate way to treat you. This appointment has two separate parts and may require you to be in the department for up to four hours. The first part will be in our simulation room and will take approximately 40 minutes. However this time frame may be shorter or longer depending on the complexity of your treatment. A Radiation Therapist will collect you from the waiting room, and ask you Radiation Therapy: Treatment to change into a gown. This will assist the staff to access the treatment area on your body whilst maintaining modesty. Once you have changed, a Radiation Therapist will provide an INITIAL TREATMENT APPOINTMENT explanation of this simulation session and answer any questions you may have. During this session, you will have your radiation therapy DATE_ _________________________________________ treatment position determined. This position is influenced by the area you are having treated, and will require the use of various pieces of equipment to ensure accurate positioning for each treatment. TIME __________________________________________ As this position needs to be accurately reproduced each day for your treatment, you may require permanent and/or non-permanent marks to assist with this process. These marks are placed on your skin with your permission, close to the area that will be treated. The permanent marks are small. What To Expect On Your First Day Of Treatment The second part to your appointment will be at QLD X-Ray at St Andrew’s Toowoomba Hospital. Here you will have a planning CT scan When you arrive on your first day (and for each subsequent day) please of the treatment area. Depending on the site you are having treated, check in with our administration staff. This is very important, as they will some extra preparation may be required for the scan. This will be alert other staff that you have arrived. You can then take a seat in the explained to you at your planning appointment. main waiting area. This planning CT scan will be slightly different from previous CT scans you may have had, as you will be positioned in your radiation therapy treatment position. Once you have left the department, your CT scan will be imported into our planning computers so a Radiation Therapist, along with your Radiation Oncologist, can create an individualised treatment plan for you. This process is complex and can require quite some time to complete. There will be two discussions on this day. The first will be with one of our Once you are positioned, you will need to stay as still and relaxed as nurses and another will be with a radiation therapist. possible. You can breathe normally as this does not affect your A member of our nursing staff will discuss your radiation treatment care. You are welcome to bring a family member, friend or carer with you. The nurse will discuss with you and provide written information about the management of your skin and possible side effects you may encounter as a result of your treatment. The side effects from radiotherapy are localised and differ between treatment sites, as well as individuals. Some people will notice minimal side effects throughout their treatment whilst others may experience them either early or late in their treatment. Generally though, side effects usually start after the second or third week of treatment and then may progress. Most side effects will continue after treatment, but are short term. These gradually improve within 4-6 weeks after treatment has finished. It is important to ask your Radiation Oncologist if you can use any medicines, creams or remedies other than those prescribed or recommended by us, as they can affect your radiation treatment. A radiation therapist will discuss your treatment with you, providing a brief explanation of the process, what is required and what you can expect. Following this you will be provided with a complete list of your appointment dates and times. What to Expect From Your Treatment Radiation therapists will be delivering your treatment and will explain what happens during the process. You will be required to lie in the same position as at your radiation therapy planning appointment. The radiation therapists will assess and adjust you every day to ensure this position is replicated each day. Treatment set-up usually takes about 5-10 minutes, and is often longer than the treatment time itself. treatment. The radiation therapists will then let you know when they are exiting the room, and you will be closely monitored at all times on the closed circuit TV systems. There are also microphones present if you need to contact a staff member. Usually, x-rays will be taken before commencing your treatment to ensure you are correctly positioned. Once treatment commences the treatment delivery may only take a few minutes. The machine will be operated from the control area outside the treatment room so it may not be necessary for the staff to come into the room until your treatment is completed. You will not feel or see anything during your treatment, but you will hear the machine operating. It is important that you remain still until staff inform you that you can move. Delays Can I father children during radiation therapy? For men having radiotherapy to their pelvic region, it is advised that you We operate on an appointment system and try to adhere to a precise do not father children during your radiation therapy treatment. Radiation timetable. However, this is not always possible. So, you may find it therapy may damage your sperm which can lead to birth abnormalities. useful to allow some extra waiting time. If you wish to father children after your radiation therapy treatment, If a machine breaks down, or if there are delays, you will be informed as please discuss your fertility with your Radiation Oncologist prior to soon as possible. If you are worried that staff are unaware you are commencing treatment. waiting, please speak to an administrative team member. Does radiation therapy make you radioactive? Radiation Therapy: Follow Up External beam radiation therapy does not make you radioactive, and it is perfectly safe for you to be with and around other people, including children, throughout your treatment. In your final week of treatment, the administration staff will organise a follow up appointment with either your Radiation Oncologist or another specialist. Please ensure you have this appointment prior to leaving the department on your last day. Can I have my mobile phone on whilst in the department? We request that all mobile phones be switched off before you enter ROQ and remain switched off while you are in the facility. We value your opinion as a patient, and welcome all your comments and suggestions – positive and negative. This is why we have created a confidential patient questionnaire for you to complete. Can I miss a radiation therapy treatment? It is important that you do not miss any appointments, as your individual radiation therapy treatment plan has been carefully calculated. However, Frequently Asked Questions Does radiotherapy affect pregnancy? Yes. It is important to ensure you are not pregnant or become pregnant at any time during radiation therapy as x-rays can harm the foetus. If you think you may be pregnant at any time during your treatment, it is extremely important that you discuss this with a member of the radiation if missing an appointment is unavoidable, please discuss this with your Radiation Oncologist as soon as you can. Is there parking available? Yes. There is free parking available close to ROQ within the St Andrew’s Toowoomba Hospital grounds. There is also parking available in the surrounding streets. therapy team immediately. If you wish to become pregnant after your radiation therapy treatment please discuss your fertility with your Radiation Oncologist prior to commencing treatment. 15 Rights And Responsibilities • Expect consultation and discussion regarding any aspect of the clients care to be conducted in total confidence and are not to be It is important that you remain informed of all aspects of your treatment released without written consent from the client, unless considered and care. The following guidelines have been adopted to ensure that you medically necessary in emergency circumstances. are aware of your responsibilities and that your rights are preserved. Right to appropriate, quality health care Right to adequate information Clients have the right to: Clients have the right to: • • Safe health care of the highest quality, maintaining standards of complete and current information concerning investigations to be professional excellence. • performed, diagnosis (to degree known) and the nature and risks of Be informed of the health care service provided including the extent of insurance coverage for services and supplementary costs. Obtain from the practitioner responsible for coordinating their care, the proposed treatment. • Have information communicated in terms they can be reasonably expected to understand. Access to care Clients have the right to: Consent • Have impartial access to treatment that is available regardless of Clients have the right to: race, creed, sex or national origin. • surgical procedures, unusual medications, participations in any Right to respect and dignity research project, photographic and audiovisual recording and other procedures where consent is required by law. Clients have the right to: • Courteous, considerate care with respect for the clients’ feelings, personal privacy and dignity at all times. Give consent based on adequate information to any anaesthesia, Second opinion All clients have the right to: Privacy and confidentiality • Any collection of information relating to your treatment is collected under Seek a second opinion. It is the individual’s responsibility to arrange this or the person responsible for their care can facilitate this. strict guidelines of the National Privacy Principles 1-10 of the Privacy Act. Clients have the right to: • Be interviewed and examined in surroundings designed to assure reasonable visual and auditory privacy. Refusal of treatment Clients have the right to: • Refuse treatment to the extent permitted by law. Client Responsibilities Clients have the responsibility to: • Advise their Radiation Oncologist if they do not understand any aspect of their care including their own condition and the purpose of their treatment before agreeing to that treatment. • Know their own health history and provide to the best of their knowledge, accurate and complete information about present complaints, past illness, hospitalisations, medications and other matters relating to their health. • If you are not satisfied with ROQ’s Internal Complaint Management System, your complaint can be directed to either the Complaints Commission or the Information Commissioner by letter, fax, in person or initially by phone. Usually your complaint should be made in writing accompanied by a complaints form, available online at: http://www.privacy.gov.au/complaints. If you have any questions about making a complaint (for example who to contact or how the process works) or if you need help in making your complaint, there is a Privacy Enquiries Line for assistance, PH: 1300 363 992. Follow the treatment and care plans recommended by the health Health Quality and Complaints Commission Office of Australian Information Commissioner Post: GPO Box 3089 Brisbane QLD 4001 Director, Compliance Office of the Privacy Commissioner GPO Box 5218 Sydney NSW 2001 In Person: Level 17 53 Albert Street Brisbane QLD 4000 Level 8 Piccadilly Tower 133 Castlereagh St Sydney NSW 2000 Phone: (07) 3120 5999 1800 077 308 (toll free outside Brisbane) 1300 363 992 Fax: (07) 3120 5998 (02) 9284 9666 Email: [email protected] [email protected] practitioners, keep appointments and inform the centre when unable to attend. • Be considerate of the rights of other patients and staff. Open Disclosure Open disclosure is the process of communicating with a patient and their support person about a patient related incident. Open disclosure provides an ethical framework for staff and Health Services to fulfil their duty of care to patients and their support persons. ROQ has a comprehensive open disclosure policy. How To Make A Complaint If you feel strongly about an issue regarding your care, there is a formal internal complaints procedure. Please ask Administration Staff for more information. Alternatively, you can arrange a meeting with the CEO or their approved delegate through any one of our staff members. Privacy Policy Disclosure Ordinarily we will not release the contents of your medical file without ROQ is committed to providing quality health care for all patients. As a your consent. However, we advise that there may be occasions where health care provider in the private sector, ROQ is bound by the National we will be required to release the details of your file irrespective of Privacy Principles provided for in the Privacy Act 1988. whether you consent to the disclosure of the information given. This will The National Privacy Principles set the standards by which we handle, occur where the law requires disclosure. Some examples are: collect, use, distribute and store personal information collected from our • There is a serious threat to an individual’s life, health and safety. • There is suspected unlawful activity. • There is a specific requirement by law, for example, when served patients. A copy of the National Privacy Principles can be found at: http://www.privacy.gov.au/law/act/npp Health information As part of our commitment to providing quality health care we maintain files containing information concerning your health history. The following types of information are maintained: with a subpoena or other court order. • It is reasonably necessary for a range of functions or activities carried out by or on behalf of a law enforcement body. • You are physically or legally incapable of giving consent and the disclosure to a person responsible for you is necessary to provide appropriate health care or treatment or for compassionate reasons • Personal details such as your name, address, date of birth. and this is not contrary to any prior wish or wish that the responsible • Medicare card number. person is aware. • Your medical history. • Past and present medications prescribed to you. Access • Notes made during the course of medical consultations We advise that as a client of this practice you have general rights of • Referrals to other health service providers. access to any information we hold concerning you. Please note there • Results and reports received from other health service providers. This information, (the medical record or file) is, at all times, the property of ROQ. Routine procedures for collecting and disclosing health information Health information is generally collected by the treating doctor during the course of the consultation. Ancillary health information may also be disclosed to specialist doctors and allied health professionals that the treating doctor may refer you to in order to continue your health care. are exceptions. We are happy to discuss these with you. Should you wish to access this information please contact the administration staff and ask for the ‘Accessing Medical Records’ form. Handling and storage of health information As part of our commitment to preserving the confidentiality of the information contained in your medical record we advise that strict secure storage policies are observed in this practice. Each member of staff understands the importance of doctor-patient confidentiality. Confidentiality Cultural Diversity Medical files are handled with the utmost respect for patient privacy. A client’s file will be accessed by the medical practitioner, and when ROQ has a cultural diversity policy which aims to promote the social, necessary, for example in the absence of a client’s usual medical cultural and economic benefits of cultural diversity for all ROQ patients, practitioner, by other medical practitioners in the practice. It may also be carers and staff. Wherever possible, ROQ will use an accredited necessary for our staff to handle medical files from time to time to professional interpreter when engaging with patients who do not address the administrative requirements of running a medical practice. understand English. Cultural difference will be respected and where ROQ staff members are bound by confidentiality requirements as a condition of employment. They sign strict confidentiality agreements practicable, incorporated into the treatment of clients. ROQ values and promotes the multicultural nature of its workforce. upon commencement of employment that remain in place during and ROQ ensures that the assessment system meets the needs of the after employment with our practice. patient and/or the carer (when appropriate), and the organisation with Such confidentiality requirements will be observed if it is necessary for accurate identification of Aboriginal and Torres Strait Islander patients. our staff to view your records. External parties and confidentiality Patient Travel Subsidy Scheme On occasion it is likely that external organisations will need to access NB: only applicable for those living in outlying areas our practice to allow us to maintain a functional workplace. Further, it may be likely that the medical records kept on site will be viewed, for example by IT contractors. Such contractors to this practice sign a confidentiality agreement, where that external organisation provides service or advice to this practice; they will be bound by the terms of the confidentiality agreement. Contact person QLD: PTSS form If your nearest treatment centre is more than 50km from your nearest local public hospital, then you may be eligible for assistance towards the cost of travel and accommodation through this state government funded scheme. If you feel that you may be eligible for assistance, your doctor or your local public hospital can supply you with a Patient Travel Subsidy Scheme (PTSS) application form. This form consists of two parts; form A Should you, at any time, have a query or complaint in relation to the – to be completed by the patient/guardian/carer and form B - to be privacy policies in place at ROQ, please contact the Administration completed by your referring practitioner. Upon completion of these two Manager, who will be happy to address any concerns you may have. forms please lodge to your local hospital for approval prior to attending your specialist appointment. Please bring relevant paperwork to your appointment for your Radiation Oncologist to sign. On completion of your treatment you should forward the completed PTSS form back to your local hospital. Falls Prevention At ROQ NSW: IPTAAS form If you are required to travel a cumulative distance of 200km in a week from your usual place of residence you may be eligible for assistance with travel We aim to make ROQ as safe as possible and accommodation through the State Government funded NSW Isolated for patients and visitors. It is felt that by Patients Travel and Accommodation Assistance Scheme (IPTASS). This raising awareness of what may cause a scheme fall may provide assistance towards the cost of travel and and providing techniques on accommodation. Your doctor, local hospital or nearest IPTAAS office can preventing falls, the risk can be reduced supply you with an application form. This needs to be completed by your or eliminated. An assessment will be referring practitioner, yourself and by your Radiation Oncologist. completed on your mobility by an ROQ On completion of your treatment you should forward the completed IPTAAS form to the IPTAAS office closest to you. If you have any Nurse. This will ensure all team members are aware of your needs and can implement correct care to reduce the risk of falls to you. enquiries please contact your nearest IPTAAS office (as detailed on the ROQ will ensure a safe environment for you at all times so as to reduce last page of IPTAAS Application Form). any risk to you and your family. Further information regarding falls prevention will be discussed with you prior to your first treatment. Accommodation Options Infection Control If you live outside Toowoomba, there is a range of accommodation within commuting or walking distance to the hospital including B&B’s, self- ROQ is committed to preventing and controlling healthcare associated contained units, motels and the Cancer Council’s Olive McMahon Lodge. infections. ROQ uses a range of procedures to reduce the risk of However, you will be responsible for organising this. Travel and infection, such as; Accommodation Assistance through the IPTAS program is available and • Washing hands with soap & using antiseptic hand rubs. • Maintaining a clean environment. • Wearing gloves, gowns, masks and goggles (when required). your local doctor can assist you in getting this approved. Please speak to one of our administration staff if you require information regarding accommodation as we have a range of brochures available for your perusal. There are a number of things you can do to reduce the risk of infection, a nurse will go through this with you on the first day of treatment and provide literature. The best way to prevent infections is to wash your hands carefully with soap & water or use a hand rub. Support Organisations NORTH ST St Andrews HOSPITAL TOOWOOMBA The Cancer Council – Helpline Phone: 13 11 20 Email: [email protected] JELLICOE ST BRIDGE ST E AV ANZAC S T Address: 137 Herries Street, Toowoomba, QLD. 4350 MARGARET ST R U T H V E N (07) 3259 8481 ST Fax: W E S T (07) 4690 5800 O S N T Phone: TAYLOR ST HO LBE RT The Cancer Council Toowoomba O S R T Address: 553 Gregory Terrace, Fortitude Valley, QLD. 4006 T Website: www.cancerqld.org.au Toowoomba Community Transport Phone: (07) 4639 6777 Fax: (07) 4639 6788 Address: PO Box 2195, Toowoomba, QLD. If You Need Medical Assistance Monday – Friday 8am – 5pm Ring your GP or ROQ – (07) 4614 5855 Email: [email protected] After hours Where To Find ROQ Toowoomba If suddenly unwell (e.g. shortness of breath, chest pain) attend an emergency department; ROQ is located in the Cancer Care Centre (Building No. 4) of St • St Vincent’s: (07) 4690 4444 enter via entrance No. 2 off North Street. • Toowoomba Base Hospital: (07) 4616 6000 The radiation therapy consultation rooms, radiation therapy planning and • St Andrew’s Hospital: (07) 4631 4666 and ask to speak with the Andrew’s Toowoomba Hospital, 280 North Street, Toowoomba. Please on-call Radiation Oncologist radiation therapy treatment units are all located on the ground floor. If necessary, there are wheelchairs located at the entrance to the Cancer Care Centre for your convenience. • Contact your local GP
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