Radiotherapy business improvement strategy

Program evaluation
01 Jul 2009
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Under the Radiotherapy Business Improvement Strategy (RT BIS), the Cancer Institute NSW with the support of NSW Health worked with the staff of 10 public radiation oncology treatment centres (ROTC) to identify opportunities for improvements in the operational practice of radiation oncology service delivery. The principle objective of this project was to provide patients with improved access to radiation oncology treatment through better-coordinated and more cost-effective service delivery.

The project was conducted in three phases from May 2006 to October 2007 and was facilitated by an external consultant, LSI Australia Pty Ltd. Project teams and steering groups were established for each centre and were responsible for setting their own targets, prioritising their own improvement initiatives and for developing their own solutions. Typically, the chief radiation therapist on each site acted as project manager. The projects were carried out by multidisciplinary teams of centre staff with external consulting support.

Each project followed a common approach, including:

  • Establishing a baseline of performance over a range of common key performance indicators.
  • Mapping current patient fl ow processes.
  • Engaging centre staff in all disciplines and at all levels in critiquing the current processes.
  • Establishing small teams to address the key problem areas identifi ed by the critiques.
  • Trialling and implementing solutions.
  • Installing a new Management Operating System to provide daily and weekly visibility on centre activity.

During the six-month baseline period prior to the commencement of the project, the 10 participating centres averaged 354 courses per potential linear accelerator per year, with only two centres meeting the NSW Health service planning figure of 414 courses per linear accelerator per year across all their linear accelerators. At the completion of all projects the participating centres averaged 411 courses per linear accelerator per year, an increase of 16 per cent.

Overall, the participating centres demonstrated an annualised theoretical increase in throughput of 1,467 courses per year. Where they existed, waiting lists were reduced in most centres.

The North Coast Cancer Centre at Port Macquarie and Coffs Harbour Base Hospitals, adopted the methodologies established through this program in the recent establishment of their radiation oncology treatment centres.

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