Jamie Bartalamay MBA, RT, Presenter: Nothing to Disclose

Loucille Jordan BS, RT, Abstract Co-Author: Nothing to Disclose

Kim Montgomery RT, Abstract Co-Author: Nothing to Disclose

Melissa Soltysik RT, Abstract Co-Author: Nothing to Disclose

Shilpen Ajit Patel MD, Abstract Co-Author: Nothing to Disclose

Purpose & Objectives: As a specialty, we strive to deliver radiation treatments safely and efficiently as well as improve patient satisfaction. Our institution recently added Volumetric Modulated Arc Therapy (Vmat) to help achieve these objectives by looking to reduce treatment times. This reduction has the joint benefits of decreasing risk of patient movement while increasing patient satisfaction with shorter visits. We undertook an analysis of radiation treatment times, to better identify areas of inefficiency and compare Vmat to traditional IMRT (Intensity-Modulated Radiation Therapy) times. In an effort to optimize the clinic for both patens and healthcare providers, our null hypothesis was: Vmat would allow the safe reduction of treatment time slots

Materials & Methods: This study broke down patient’s treatment delivery into sections to highlight the impact of our new software while revealing areas of inefficiency. Data was collected over 30-days by therapist on a single machine utilizing Vmat, IMRT, and SBRT (Stereotactic Body Radiation Therapy) between Aug-Sept 2013. All patients received pre-treatment imaging utilizing CBCT (Cone Beam CT). SBRT patients required approval of CBCT by physician while non-SBRT patients did not require physician pre-approval and were reviewed by treatment therapists. Example of how we segmented treatment deliveries included: 1. Appointment time: Patient’s scheduled time (tracking method) 2. Patient in Room: Patient in room 3. Start CBCT: Patient set-up and CBCT started 4. Beam On: Imaging completed, equipment retracted if needed, and start of treatment beam 5. End of Treatment: Treatment beam completed 6. Patient out of Room: Patient out of room

Results: Total treatment times for Vmat plans ranged from 8 to 47 minutes with the average treatments at 16; 43 minutes for SBRTs. In comparison, treatment times for non-SBRT IMRTs ranged from 13 to 21 minutes. Active beam time dropped from 8 to 5 minutes. Vmat and IMRT, CBCT review by therapists was 4 minutes, while those requiring a physician averaged 20 minutes

Conclusions: Systematically documenting the various components of treatment delivery pinpointed areas of improvement in patient care. From our results, we concluded that Vmat alone was not enough to reduce appointment times. This data allowed the team to discuss potential solutions while drawing attention to an unknown issue. Our physicists discovered the machine settings had not been adjusted to accept higher monitor units associated with Vmat plans. An adjustment was made as well as plans modified resulting in reduced physical beam time and eliminated need for imaging equipment retraction Additionally, we reviewed process improvements with our physicians for CBCT approvals. With the increase in new technologies, it is imperative that our implementation teams do their due diligence with all new systems

Bartalamay, J, Jordan, L, Montgomery, K, Soltysik, M, Patel, S, Improvement in Radiation Treatment Delivery.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14042292.html