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Abstract：
OBJECTIVE: External beam radiotherapy is a complex process, involving timely coordination among multiple teams. The aim of this study is to report our experience of establishing a standardized workflow and using quantitative data and metrics to manage the time-to-treatment initiation (TTI).
METHODS: Starting in 2014, we established a standard process in a radiation oncology-specific electronic medical record system (RO-EMR) for patients receiving external beam radiation therapy in our department, aiming to measure the time interval from simulation to treatment initiation, defined as TTI, for radiation oncology. TTI data were stratified according to the following treatment techniques: three-dimensional (3D) conformal therapy, intensity-modulated radiotherapy (IMRT), and stereotactic body radiotherapy (SBRT). Statistical analysis was performed with the Mann-Whitney test for the respective metrics of aggregate data for the initial period 2012- 2015 (PI) and the later period 2016-2019 (PII).
RESULTS: Over 8 years, the average annual number of treatments for PI and PII were 1760 and 2357 respectively, with 3D, IMRT, and SBRT treatments accounting for 53, 29, 18% and 44, 34, 22%, respectively, of the treatment techniques. The median TTI for 3D, IMRT, and SBRT for PI and PII were 1, 6, 7, and 1, 5, 7 days, respectively, while the 90th percentile TTI for the three techniques in both periods were 5, 9, 11 and 4, 9, 10 days, respectively. From the aggregate data, the TTI was significantly reduced (p = 0.0004, p < 0.0001, p < 0.0001) from PI to PII for the three treatment techniques.
CONCLUSIONS: Establishing a standardized workflow and frequently measuring TTI resulted in shortening the TTI during the early years (in PI) and maintaining the established TTI in the subsequent years (in PII).
METHODS: Starting in 2014, we established a standard process in a radiation oncology-specific electronic medical record system (RO-EMR) for patients receiving external beam radiation therapy in our department, aiming to measure the time interval from simulation to treatment initiation, defined as TTI, for radiation oncology. TTI data were stratified according to the following treatment techniques: three-dimensional (3D) conformal therapy, intensity-modulated radiotherapy (IMRT), and stereotactic body radiotherapy (SBRT). Statistical analysis was performed with the Mann-Whitney test for the respective metrics of aggregate data for the initial period 2012- 2015 (PI) and the later period 2016-2019 (PII).
RESULTS: Over 8 years, the average annual number of treatments for PI and PII were 1760 and 2357 respectively, with 3D, IMRT, and SBRT treatments accounting for 53, 29, 18% and 44, 34, 22%, respectively, of the treatment techniques. The median TTI for 3D, IMRT, and SBRT for PI and PII were 1, 6, 7, and 1, 5, 7 days, respectively, while the 90th percentile TTI for the three techniques in both periods were 5, 9, 11 and 4, 9, 10 days, respectively. From the aggregate data, the TTI was significantly reduced (p = 0.0004, p < 0.0001, p < 0.0001) from PI to PII for the three treatment techniques.
CONCLUSIONS: Establishing a standardized workflow and frequently measuring TTI resulted in shortening the TTI during the early years (in PI) and maintaining the established TTI in the subsequent years (in PII).
摘要：
目的：外照射放射治疗是一个复杂的过程，涉及多个团队之间的及时协调。这项研究的目的是报告我们建立标准化工作流程并使用定量数据和指标来管理治疗开始时间（TTI）的经验。
方法：从2014年开始，我们为在我们部门接受外部束放射治疗的患者在放射肿瘤学专用电子病历系统（RO-EMR）中建立了标准流程，旨在测量从模拟到治疗开始的时间间隔，定义为TTI，放射肿瘤学。TTI数据根据以下治疗技术进行分层：三维（3D）适形治疗，调强放疗(IMRT),和立体定向身体放射治疗（SBRT）。采用Mann-Whitney检验对2012-2015年初期（PI）和2016-2019年后期（PII）的汇总数据的各个指标进行统计分析。
结果：超过8年，PI和PII的平均年处理次数分别为1760和2357，3D,IMRT,SBRT治疗占53、29、18%和44、34、22%，分别,治疗技术。3D的中位TTI，IMRT,PI和PII的SBRT分别为1、6、7和1、5、7天，分别,而在这两个时期中，三种技术的第90百分位TTI分别是5、9、11和4、9、10天，分别。从聚合数据中，对于三种治疗技术,TTI从PI到PII显著降低(p=0.0004,p<0.0001,p<0.0001)。
结论：建立标准化工作流程并频繁测量TTI会导致在早期（PI）缩短TTI，并在随后的几年（PII）维持已建立的TTI。
方法：从2014年开始，我们为在我们部门接受外部束放射治疗的患者在放射肿瘤学专用电子病历系统（RO-EMR）中建立了标准流程，旨在测量从模拟到治疗开始的时间间隔，定义为TTI，放射肿瘤学。TTI数据根据以下治疗技术进行分层：三维（3D）适形治疗，调强放疗(IMRT),和立体定向身体放射治疗（SBRT）。采用Mann-Whitney检验对2012-2015年初期（PI）和2016-2019年后期（PII）的汇总数据的各个指标进行统计分析。
结果：超过8年，PI和PII的平均年处理次数分别为1760和2357，3D,IMRT,SBRT治疗占53、29、18%和44、34、22%，分别,治疗技术。3D的中位TTI，IMRT,PI和PII的SBRT分别为1、6、7和1、5、7天，分别,而在这两个时期中，三种技术的第90百分位TTI分别是5、9、11和4、9、10天，分别。从聚合数据中，对于三种治疗技术,TTI从PI到PII显著降低(p=0.0004,p<0.0001,p<0.0001)。
结论：建立标准化工作流程并频繁测量TTI会导致在早期（PI）缩短TTI，并在随后的几年（PII）维持已建立的TTI。
