Routine physics work efficacy and efficiency improvement through a shared-duty physicist-of-the-day model in a multi-hospital radiation oncology network.

چکیده اصلی

BACKGROUND: Large multi-hospital radiation oncology networks often rely on site-exclusive physicist coverage models that can lead to imbalanced workload distribution, inconsistent task execution, communication fragmentation, and vulnerability to delayed or missed quality checks. Increasing clinical complexity and distributed staffing models necessitate operational strategies that improve efficiency, standardization, and safety across geographically separated sites. PURPOSE: To describe the implementation of a shared-duty physicist-of-the-day (POD) model supported by a real-time operational dashboard and to evaluate its impact on workload distribution, task efficiency, and safety metrics across a multi-hospital radiation oncology network. METHODS: A structural transition from a site-exclusive to a shared-duty POD model was implemented in our institution-a four-site academic radiation oncology system. A custom application, RadOncStatusBoard, was developed using structured query language (SQL)-based integration with the Mosaiq Record & Verify system to aggregate real-time patient appointments, treatment progress, quality checklist (QCL) items, and weekly chart check (WCC) eligibility. Microsoft Teams channels were used for daily communication and task coordination. Operational data from two matched 21-month intervals-before and after POD restructuring-were extracted using SQL. Evaluated metrics included task volumes, claim times, completion times, WCC performance, billing accuracy, and dosimetry-related Radiation Oncology Incident Learning System (RO-ILS) event reporting. Right-skewed distributions were summarized using medians and interquartile ranges (IQR). Surveys of physicists and dosimetrists were performed to assess end-user perceptions of workflow and safety. RESULTS: Workload balance improved across all task categories, with substantial decreases in main-to-satellite task ratios (e.g., the ratio for chart close decreased from 1.91 to 1.27). Task claim and completion times decreased markedly at both main and satellite locations (e.g., chart-close claim time decreased from 36.8 to 6.2 min at the main campus). WCC completion improved from 97.7% to 99.9%, and WCC charge capture increased from 96.1% to 99.4%. The proportion of dosimetry-related RO-ILS events decreased numerically from 31.0% to 26.7% (p = 0.339). Survey responses from physicists and dosimetrists indicated improved workflow clarity, communication, workload balance, and perceived patient safety. CONCLUSIONS: Implementation of a shared-duty POD model improved workload balance, enhanced operational efficiency, and strengthened routine safety processes across a multi-site radiation oncology program. Integration of a real-time operational dashboard, standardized communication pathways, and structured task-claiming workflows enabled measurable gains in responsiveness, compliance, and perceived safety culture.

متن کامل اصلی