Waiting Times as a Quality Indicator for IMRT/VMAT Cases in the Radiotherapy Department: A Retrospective Study from a Tertiary Hospital in Saudi Arabia

Abstract

Aim: To analyze the feasibility process and the compliance of our workflow to our protocol for cases treated with IMRT and VMAT. Material and Methods: A retrospective analysis of IMRT cases treated between October 2010 and December 2014. Waiting times from the radiotherapy request to treatment start (REQ-ST), from the radiotherapy request to CT Simulation (REQ-CT) and from CT Simulation to treatment start (CT-ST), were computed. To assess the compliance of our performance with the protocol of ≤10 WD, we calculated two indicators: mean waiting times and compliance rates. The cut-off of compliance for CT-ST is defined by our protocol. Using ≤10 WD, the two other cut-offs were respectively calculated using a linear equation of REQ-ST and REQ-CT as a function of CT-ST, giving a REQ-CT=9 weekdays (WKD) and REQ-ST=26 WKD. Results: A total of 245 cases of IMRT were included. The mean duration and standard deviation ±SD CT-ST, REQ-ST and REQ-CT was 13.80 ± 5.07 WD, 30 ± 10 WKD, 11.26 ± 8.33 WKD, respectively. The compliance rate of CT-ST, REQ-ST and REQ-CT with the protocol timeline was 16%, 33% and 49%, respectively. Due to the low compliance rates; we proposed to update our protocol with more feasible timelines: CT-ST ≤ 15 WD; REQ-ST ≤ 31 WKD; REQ-CT ≤ 12 WKD. Consequently, the respective compliance rates were raised to 79% for CT-ST, 68% for REQ-CT and 60% for REQ-ST. Conclusion: In order to conciliate quality of care standards and practicable goals, it seems appropriate to adjust the protocol timeline whilst simultaneously trying to improve procedural and patient compliance.