Strategic Management and Reduction of Treatment Delays in Radiotherapy (Smart – Rad) – A Prospective Quality Improvement Study from a Tertiary Cancer Centre in South India

Abstract

Background: Prolonged waiting times for daily radiation treatment negatively impact patient satisfaction, adherence, and workflow efficiency in radiotherapy centers. Our centre is a tertiary care centre with a high workload, treating around 300 patients a day. The average waiting time was recorded as 54 minutes, which led to patient dissatisfaction. To overcome this, this study was conducted to implement targeted quality improvement interventions to reduce waiting times and optimize treatment workflows.

Methods: A baseline analysis identified key inefficiencies through fishbone and 2x2 matrix analyses. Contributing factors included inefficient scheduling, non-compliance with appointment timings, manpower shortages, and a lack of imaging protocols. Interventions included spaced scheduling, priority slots for special cases, patient and staff education, dedicated coordination personnel, and weekly process reviews. Statistical analysis of pre- and post-intervention waiting times was conducted to evaluate outcomes.

Results: The implementation of interventions reduced the average waiting time from 54 minutes to 36 minutes exceeding our expectation of 40 minutes. Improved patient adherence, enhanced workflow efficiency, and better utilization of the treatment unit were observed. A comparative analysis with global literature highlighted the effectiveness of the multi-faceted approach, achieving results comparable to advanced centers using more resource-intensive strategies.

Conclusion: This quality improvement initiative demonstrates that systematic interventions tailored to institutional needs can significantly reduce waiting times in radiotherapy.