Strategic Reduction of Package Time in Head and Neck Cancer

Abstract

<h3>Purpose/Objective(s)</h3> "Total package time (TPT)" or the time from diagnosis to completion of all definitive treatment has been associated with outcomes for a variety of tumor sites, but especially to head and neck cancers. Head and neck cancer patients often undergo a complex diagnosis and treatment process involving multiple disciplines both within and outside of oncology. This complexity can lead to longer package times and each involved discipline has the responsibility to maintain an efficient and effective process. Strategic intervention to improve package time must involve not only new technology or tools, but also "soft" components such as accountability, motivation, and leadership. This combination is necessary to affect true optimization of a workflow or process such as the radiation therapy of head and neck cancer patients leading to shorter TPT for these patients. <h3>Materials/Methods</h3> Two interventions were strategically executed to improve radiation therapy workflow: upgrade of the treatment planning system (TPS) to one more efficient at optimization and dose calculation and implementation of an automated patient management and accountability system. The radiation therapy-related timelines of 112 HN patients treated over the last two years were reviewed and the average time differences were compared between the patient populations before and after the strategic interventions. <h3>Results</h3> Purely upgrading the TPS did not show significant improvements, but when combined with the patient management system, significant improvement in radiation-related package time can be noted for every timepoint. The overall reduction of radiation-related package time was statistically significant at 22.85 days (p = 0.002). <h3>Conclusion</h3> On face value, the patient management system could be credited as responsible for the improvement, but on qualitative analysis, it is clear that it only played a role in the time reduction. The new system is only a tool which can be ignored or under-utilized. Due to the addition of important "soft" components such as accountability, motivation, and leadership, the tool was optimized and implemented in such a manner as to have the desired effect.