A national perspective about the current work situation at modern radiotherapy departments

Abstract

Background: The radiotherapy (RT) community faces great challenges to meet the growing cancer incidence, especially regarding workload and recruitment of personnel. Workflow-related issues affect involved professions differently since they have specific expertise and various roles in the workflow. To obtain an objective understanding of the current working situation and identify workflow bottle necks in RT, we conducted a national survey on this topic in 2018.

Materials and methods: All 17 (photon-based) RT departments in Sweden were invited to participate in the study, which targeted both managers and employees in RT. Descriptive statistics were calculated for each profession and for small, medium and large departments (2/3-4/≥5 linacs).

Results: Altogether, 364 filled-in questionnaires were returned (32/332 managers/employees; 94% response rate). Managers reported a general need for more staff (all professions). Small departments reported no problems with waiting times (0/3); whereas 2/3 of medium and large departments did (medium: 5/8, large: 2/3). All professions had a positive attitude towards working in RT (mean = 86%, 0/100%=negative/positive attitude). Organizational issues were ranked highest among reoccurring events that were most frustrating/had most negative effect on the work environment. The most severe workflow-related problems were reported to originate at contouring.

Conclusion: Future efforts to improve the modern RT workflow need to focus on how to make positive mechanisms at small departments useful in larger settings. Our data also reveal that strong leadership and improved routines at contouring are warranted by all RT professions to reduce frustration related to organizational issues and to increase work effectivity.

Keywords: Organization; Radiotherapy; Staff; Workflow.

Fig. 1

Schematic of the study recruitment procedure. Managers estimated the total number of health-care professionals working in Swedish radiotherapy to 731.

Fig. 2

a–d: Spent time on radiotherapy tasks by profession and department size during a mean regular workweek. NB: 2/1/1 small/medium/large departments used service contracts for maintenance.

Fig. 2

a–d: Spent time on radiotherapy tasks by profession and department size during a mean regular workweek. NB: 2/1/1 small/medium/large departments used service contracts for maintenance.

Fig. 3

a–d: Radiotherapy workflow issues by profession and department size. (a) Dependence on others to be handled tasks; (b) Cannot start a task due to delays in earlier stages of the process; (c), Cannot complete a task because having to wait on someone; (d) Disrupted/disturbed to an extent affecting work-effectivity. (a): during a regular day; (b)-(d) during a regular week.