1077 - Routine Physics Work Efficacy and Efficiency Improvement with Duty Shared Among Daily Physicist Group for a Multi Hospital Radiation Oncology Network

G. P. Chen, D. E. Prah, and E. S. Paulson; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI

Purpose/Objective(s): Recently we changed our physics coverage model from individual physicists working at separate clinics to an approach in which routine physics work is shared among a team of physicists of the day (PODs) in a multi-hospital radiation oncology network. The purpose of this work was 1) to develop a software dashboard to display patient treatment status, and routine physics work list in a centralized task board for the POD team, and 2) to evaluate the efficacy and efficiency of the routine physics work structure change. Materials/

Methods: Physics work performed in a Radiation Oncology network with a main campus (3 Elekta Linacs, 1 Accuray RadiXact, 1 Elekta MR Linac) and 3 satellites (1 Elekta linac each) utilizing one record and verify (R&V) system was evaluated. 2 PODs are assigned to the main campus and 1 at each satellite. Data stored in the R&V system was retrieved via structured language query within a program developed using C++. Daily patient appointments on all treatment machines were displayed alternatively to show 1) the number of patients scheduled, finished, cancelled, on hold, or did not show, on a bar chart, and 2) appointment completion status in chronological axis on a Gantt chart. The completed number of fractions and WCC status for each patient is assessed. Patients due for WCC are displayed in color coded list to show check readiness, along with daily treatment location and status, fractions remaining until next WCC, who and when the last WCC was performed, and when the last WCC charge was dropped. Quality check list (QCL) tasks placed into the R&V system by dosimetrists and therapists for routine physics work, including on-screen and plan transfer check, chart closes, treatment reviews, etc, are listed together in a queue with the activity, location and claimer with color code indicating urgency of the due date/time. POD team members pick a task based on individual availability, task urgency, the physicist who performed the last patient WCC, treatment machine schedule, etc. The list is updated in a preset interval of 5 minutes to refresh the status. The WCC completion rate, defined as the ratio of the total number of eligible WCCs performed in all 5-fraction cycles of each course and the total number of required WCCs, as well as the average completion time of all QCL items, and the ratio of average daily completed number of QCL items per POD team member at the main campus and that at the satellites (Rm2s), were compared before and after the routine physics work structure change.
Results: After the routine physics work structure change, the WCC completion rate increased from 96.8% to 99.8%. The average physics on-screen and chart check completion times reduced from 346.2 minutes to 100.5 minutes. The value of Rm2s dropped from 3.36 to 1.83.
Conclusion: A software dashboard has been developed and used for routine physics work shared among PODs in a multi-hospital network, resulting in increased physics WCC completion rate, balanced workload among POD team members and increased physics plan check efficiency.