Process management and scheduing [sic] in radiation therapy

Abstract

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Management of complex, advanced technology, high cost, and high risk operations requires reliance on systems engineering principles. This approach has been common place in the management of nuclear power plants for decades. Despite the advances in modern health care and modern radiation therapy (RT) and increasing complexity and cost of these operations, management in this area is still largely based on legacy approaches. In 1995 the National Academy of Engineering and the Institute of Medicine published a report, Building a Better Delivery System, in which applications of systems engineering principles in healthcare design and management were outlined. This work explores the applicability and utility of systems thinking in the design and management of RT. The work consists of three projects: RT process mapping using IDEF0, performance data collection in RT, and modeling of RT scheduling systems. The projects are aimed at improving quality, safety, and efficiency of RT operations by enabling definition of processes, systematic process data collection, and analysis of operations. The presented work shows that IDEF0 is well suited for modeling of RT operations. The developed data collection processes demonstrate that the electronic work environment of modern RT operations is well suited for systematic data collection for the purposes of process management and improvement. Lastly, the analysis of scheduling models in RT demonstrated that the conventional scheduling models are inadequate and that the electronic work environment has the potential to improve the scheduling process in RT which is in turn expected to improve quality, safety, and efficiency of RT operations.