Linear accelerator utilization: Concept and tool to aid the scheduling of patients for radiotherapy. (December 2021)

• Record Type: Journal Article
• Authors: Lindberg, Jesper; Björk-Eriksson, Thomas; Olsson, Caroline E.
• Is Part Of: Technical innovations & patient support in radiation oncology. Volume 20(2021)
• Page Start: 10
• Page End: 16
• Publication Date: 2021-12
• Subjects: Radiotherapy -- Scheduling -- Capacity -- Utilization -- Tool; LUR Linac utilization rate -- OIS Oncology information system; Radiotherapy -- Periodicals; Cancer -- Radiotherapy -- Periodicals; Cancer -- Patients -- Hospital care -- Periodicals; 615.842
• DOI: 10.1016/j.tipsro.2021.09.001
• Languages: English
• ISSNs: 2405-6324

Abstract

Highlights: Linacs were fully booked already three weeks before a majority of investigated days. Non-treatment events were scheduled ≤ 11% for the investigated time period. Planned booking scenarios deviated from real scenarios for most investigated days. Largest changes were primarily related to linac downtime/maintenance issues. Tool visualizing linac utilization may aid staff to achieve an even RT workflow. Abstract: Background and purpose: Resources in radiotherapy (RT) need to be used effectively to meet the current clinical demand. The aim of this data-driven study is to identify temporal trends in the scheduling of patients for RT and to develop a tool for a visual overview of future scheduling levels. Material and methods: Scheduling data at an eight-linac modern RT department in Sweden were collected twice daily for planned and observed linac use in 2018–2020. Information was retrieved each day for the present (Day 0) and the forthcoming 100 weekdays with total linac utilization rates (LURs) calculated for two activity categories: treatment and non-treatment . An in-house tool based on the LUR concept, database queries from the oncology information system (OIS)/automatic calculations was developed and evaluated by RT managers and scheduling staff (n = 10). Results: Overall median LURs were 87%/89% (planned/observed; p < 0.01) with more frequent and larger daily increase for non-treatment activities compared with treatment activities. LUR increased with shorter planning horizons and reached 100% for fully-operating linacs ≈3 weeks before Day 0. The tool was reported by 88% to ease the work and to contribute towards an even scheduling of patients (responses: 8/10). Conclusion: Alterations from a planned RT schedule occurs frequently. Having a tool that helps to reduce the abundance of booking information into clinically relevant overviews promise to increase the understanding of present and future scheduling levels. Our proposed concept and tool suggest that this is a feasible approach to schedule patients for RT more evenly.