Redesign of process map to increase efficiency: Reducing procedure time in cervical cancer brachytherapy
Redesign of process map to increase efficiency: Reducing procedure time in cervical cancer brachytherapy
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DOI：
10.1016/j.brachy.2014.11.016
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发表时间：
2015-07-01
期刊：
影响因子：
1.9
通讯作者：
Viswanathan, Akila N.
中科院分区：
文献类型：
--
作者：
Damato, Antonio L.;Lee, Larissa J.;Viswanathan, Akila N.
目的：通过重新设计宫颈癌近距离放疗过程图，提高术中临床资源利用效率，减少宫颈癌近距离放疗计划时间。方法和材料：一个多学科团队确定了本院宫颈癌近距离治疗的所有任务和相关资源，并将其安排在流程图中。以最小化计划时间为目标，对流程图的治疗计划组件进行了重新设计。测量20个连续插入的计划时间，其中10个使用标准流程，10个使用重新设计的流程图，并对结果进行比较。采用双尾t检验，差异有统计学意义（p < 0.05）。结果：确定了宫颈癌近距离放疗治疗涉及的12个任务。流程图显示，在标准程序中，治疗计划任务是依次执行的。对流程图进行了重新设计，指定轮廓和一些规划任务同时执行。重新组织了一些质量保证任务，以尽量减少可能的错误对程序时间的不利影响。试验干运行后，现场实施证实了新的工艺图对临床条件的适用性。引入重新设计的流程图后，计划时间减少了29% （p < 0.01）。结论：生成了宫颈癌近距离放疗的过程图。重新设计了流程图的处理计划组件，从而减少了29%的计划时间，并简化了质量保证过程。(C) 2015美国近距离放射治疗学会。Elsevier Inc.出版。版权所有。
PURPOSE: To increase intraprocedural efficiency in the use of clinical resources and to decrease planning time for cervical cancer brachytherapy treatments through redesign of the procedure's process map.METHODS AND MATERIALS: A multidisciplinary team identified all tasks and associated resources involved in cervical cancer brachytherapy in our institution and arranged them in a process map. A redesign of the treatment planning component of the process map was conducted with the goal of minimizing planning time. Planning time was measured on 20 consecutive insertions, of which 10 were performed with standard procedures and 10 with the redesigned process map, and results were compared. Statistical significance (p < 0.05) was measured with a two-tailed t test.RESULTS: Twelve tasks involved in cervical cancer brachytherapy treatments were identified. The process map showed that in standard procedures, the treatment planning tasks were performed sequentially. The process map was redesigned to specify that contouring and some planning tasks are performed concomitantly. Some quality assurance tasks were reorganized to minimize adverse effects of a possible error on procedure time. Test dry runs followed by live implementation confirmed the applicability of the new process map to clinical conditions. A 29% reduction in planning time (p < 0.01) was observed with the introduction of the redesigned process map.CONCLUSIONS: A process map for cervical cancer brachytherapy was generated. The treatment planning component of the process map was redesigned, resulting in a 29% decrease in planning time and a streamlining of the quality assurance process. (C) 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.