title: Time management in radiation oncology: development and evaluation of a modular system based on the example of rectal cancer treatment. The DEGRO-QUIRO trial.
abstract: OBJECTIVE
  The goal was to develop and evaluate a modular system for measurement of the work times required by the various professional groups involved in radiation oncology before, during, and after serial radiation treatment (long-term irradiation with 25-28 fractions of 1.8 Gy) based on the example of rectal cancer treatment.
  
  
  METHODS
  A panel of experts divided the work associated with providing radiation oncology treatment into modules (from the preparation of radiotherapy, RT planning and administration to the final examination and follow-up). The time required for completion of each module was measured by independent observers at four centers (Rostock, Bamberg, Düsseldorf, and Offenbach, Germany).
  
  
  RESULTS
  A total of 1,769 data sets were collected from 63 patients with 10-489 data sets per module. Some modules (informed consent procedure, routine treatments, CT planning) exhibited little deviation between centers, whereas others (especially medical and physical irradiation planning) exhibited a wide range of variation (e.g., 1 h 49 min to 6 h 56 min for physical irradiation planning). The mean work time per patient was 12 h 11 min for technicians, 2 h 59 min for physicists, and 7 h 6 min for physicians.
  
  
  CONCLUSIONS
  The modular system of time measurement proved to be reliable and produced comparable data at the different centers. Therefore, the German Society of Radiation Oncology (DEGRO) decided that it can be extended to other types of cancer (head and neck, prostate, and breast cancer) with appropriate modifications.
authors.affiliation: Department of Radiation Oncology, Erlangen University Hospital, Universitätsstr. 27, 91054, Erlangen, Germany. rainer.fietkau@uk-erlangen.de
authors.forename: R
authors.initials: R
authors.lastname: Fietkau
authors.forename: W
authors.initials: W
authors.lastname: Budach
authors.forename: N
authors.initials: N
authors.lastname: Zamboglou
authors.forename: H-J
authors.initials: HJ
authors.lastname: Thiel
authors.forename: H
authors.initials: H
authors.lastname: Sack
authors.forename: W
authors.initials: W
authors.lastname: Popp
mesh_terms: D000465:Algorithms; D003299:Cooperative Behavior; D019583:Dose Fractionation, Radiation; D005858:Germany; D006801:Humans; D033183:Interdisciplinary Communication; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D018787:Radiation Oncology / Q000458:organization & administration*; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards*; D012004:Rectal Neoplasms / Q000532:radiotherapy*; D012955:Societies, Medical; D017748:Time Management / Q000458:organization & administration*; D013996:Time and Motion Studies; D016526:Workload