Process evaluation of treatment times in a large radiotherapy department. Issue 3 (August 2016)

• Record Type: Journal Article
• Authors: Beech, R.; Burgess, K.; Stratford, J.
• Is Part Of: Radiography. Volume 22:Issue 3(2016)
• Page Start: 206
• Page End: 216
• Publication Date: 2016-08
• Subjects: Scheduling -- Room-occupancy -- Appointment -- Time -- Throughput -- Provision; Diagnostic imaging -- Periodicals; Radiotherapy -- Periodicals; Cancer -- Radiotherapy -- Periodicals; Diagnostic Imaging -- Periodicals; Neoplasms -- Periodicals; Radiotherapy -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Radiothérapie -- Périodiques; Cancer -- Radiothérapie -- Périodiques; Electronic journals; 616.0757
• DOI: 10.1016/j.radi.2016.03.001
• Languages: English
• ISSNs: 1078-8174

Abstract

Abstract: Purpose/objective: The Department of Health (DH) recognises access to appropriate and timely radiotherapy (RT) services as crucial in improving cancer patient outcomes, especially when facing a predicted increase in cancer diagnosis. There is a lack of 'real-time' data regarding daily demand of a linear accelerator, the impact of increasingly complex techniques on treatment times, and whether current scheduling reflects time needed for RT delivery, which would be valuable in highlighting current RT provision. Material/methods: A systematic quantitative process evaluation was undertaken in a large regional cancer centre, including a satellite centre, between January and April 2014. Data collected included treatment room-occupancy time, RT site, RT and verification technique and patient mobility status. Data was analysed descriptively; average room-occupancy times were calculated for RT techniques and compared to historical standardised treatment times within the department. Results: Room-occupancy was recorded for over 1300 fractions, over 50% of which overran their allotted treatment time. In a focused sample of 16 common techniques, 10 overran their allocated timeslots. Verification increased room-occupancy by six minutes (50%) over non-imaging. Treatments for patients requiring mobility assistance took four minutes (29%) longer. Conclusion: The majority of treatments overran their standardised timeslots. Although technique advancement has reduced RT delivery time, room-occupancy has not necessarily decreased. Verification increases room-occupancy and needs to be considered when moving towards adaptive techniques. Mobility affects room-occupancy and will become increasingly significant in an ageing population. This evaluation assesses validity of current treatment times in this department, and can be modified and repeated as necessary. Highlights: A process evaluation examined room-occupancy for various radiotherapy techniques. Appointment lengths were found to be appropriate for more complex techniques. Room-occupancy overran appointment lengths for more common radiotherapy techniques. Online and offline imaging and reduced patient mobility increased room-occupancy.