Evaluating radiotherapy treatment delay using Failure Mode and Effects Analysis (FMEA)

Area of Science:

• Medical Physics
• Radiation Oncology
• Healthcare Management

Background:

• Delays in radiation therapy clinical workflow can significantly impact patient treatment and healthcare resource utilization.
• Optimizing the pre-treatment process, from CT simulation to treatment delivery, is crucial for efficient patient care.

Purpose of the Study:

• To identify and evaluate factors causing delays in the radiation therapy clinical workflow using Failure Mode and Effects Analysis (FMEA).
• To assess the impact of these delays on patient treatment and hospital resources.

Main Methods:

• Retrospective analysis of 1106 patient cases using FMEA methodology.
• Rating of failure modes (FMs) based on occurrence, severity, and detectability.
• Introduction and calculation of social effect (SE) and economic effect (EE) for each FM, alongside Risk Priority Number (RPN) and RPN_SE-EE.

Main Results:

• Identified factors causing delays in radiation therapy pre-treatment processes.
• CT simulation (CT-Sim) and treatment planning stages exhibited the highest number of FMs with high RPN values.
• Average delay caused by identified FMs was 8 days, with 76% of FMs causing delays under 5 days.

Conclusions:

• FMEA effectively identified critical delay factors in radiation therapy pre-treatment.
• CT-Sim and treatment planning require prioritized improvements due to high RPN values.
• The novel SE and EE factors provide valuable insights into the broader impact of workflow delays.