ESTRO 2024 - Abstract Book

S2945

Interdiscplinary - Other

ESTRO 2024

An extensive data analysis revealed that there was essentially no capacity problem, but a scheduling problem. Although the number of CTs increased significantly in the period from 2019 to 2021, the maximum number of weekly CTs was hardly ever crossed. However, the distribution of CTs over the weekdays and the working hours per day were skewed: many more CTs were scheduled on Monday and Tuesday in comparison to the other weekdays, see Figure 1. There was a daily peak of scheduled CTs between 10:00-11:00 am and between 1:00-3:00 pm.

Furthermore, a number of CTs were not scheduled as real time appointments but scheduled as five minutes directly following the first intake with the RTO, called a drop-in CT. The RTTs working at the CT had to decide on the spot whether the CT appointment had to be rescheduled or the patient could wait for the CT to be performed directly. This working procedure negatively affected the perceived workload and caused a lot of uncertainty and stress among the RTT. This procedure was agreed on to increase value for the patient, since two appointments could then be combined on one day, resulting in time and travel savings for our patients. A daily analysis of actual required time on the CT scan versus the scheduled time presented many deviations and improvement possibilities. Multiple countermeasures were agreed on and implemented. For example: scheduling appointments separated for every CT; adjustment of appointment times per treatment site; shift in weekdays for several CTs; no drop-in CTs for breast cancer patients scheduled in the program, but the RTO and RTT discuss the possibility for a direct time slot on the CT directly after the RTO appointment. All these countermeasures resulted in less variation in CT utilization and a better spread over the weekdays, see figure 2. Monday and Tuesday still remained the busiest days due to the combination with the doctor’s appointment which are scheduled more frequently on these days and the combination of the first radiotherapy treatment with chemotherapy which mostly starts on Mondays.