Creating a Tool to Maximize Scheduling Efficiency on a Magnetic Resonance Linear Accelerator Unit

Aim Efficient scheduling on a stand-alone Magnetic Resonance Linear Accelerator (MRL) unit can be time-consuming and frustrating for those working on the unit as it takes time away from the clinical duties of a radiation therapist (RTT). Duration of treatment and urgency of start date varies depending on treatment protocol and manual searches for appropriate start dates are often required. The aim of this project was to decrease the time RTTs spend optimizing the MRL treatment schedule by 25% with implementation of an electronic scheduling tool. Process This project was conducted from October 2022 to April 2023. Patient scheduling was done using MOSAIQ by booking clerks but relied on RTTs to identify the next available start date. To understand the magnitude of the problem, the time spent by RTTs on scheduling was recorded and categorized by task from December 2022 to March 2023. To retrieve scheduling information, staff were given access to a custom Crystal Report in MOSAIQ log in. An Excel tool was created in house using Microsoft Office Standard 2013 that sorted key information exported from MOSAIQ to meet the needs of MRL staff. RTTs were able to select potential start date and the tool indicated availability by displaying colour indicators beside each date. The amount of time spent on scheduling by RTTs as well as staff satisfaction were compared between pre and post implementation of Excel tool. Benefits/Challenges RTTs are consistently challenged with a far-reaching scope of practice which includes treatment planning, treatment delivery, and patient care. On MRL, staff are furthering their learning by adapting to MR environment, embracing new research studies and learning new software interfaces. Reducing time spend on scheduling tasks can allow staff to focus on other parts of their job that may be more fulfilling for them. The challenge of this project was to provide a seamless and cost-effective process that required technical considerations for exporting patient sensitive information from MOSAIQ. Impact/Outcomes From December 13, 2022 to March 8, 2023, 22 scheduling activities were recorded and 80% of those scheduling activities were to forecast start dates. The average time spent scheduling these activities was 32 min (range 10-60min) with an outlier of 2 hours. Staff training occurred from March 13-15, 2023, and the Excel tool was implemented on March 16, 2023. From March 13, 2022 to April 11, 2023, there were 14 instances of forecasting start dates and the average time was 11 min (range 5-15min). This is a 50%-75% decrease in time spent on scheduling. Process measures showed that in all forecasting tasks, the staff was using the tool and there were no problems in utilizing the start date during booking by unit coordinators. Staff satisfaction survey showed continued dissatisfaction with the current scheduling process even after implementation, but an increased satisfaction on the workload associated with scheduling. This project served as a pilot on the use of this tool and has since expanded to include other dose and fractionation such as for prostate and pancreas sites.