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Updated: Jan 5, 2026

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

Published on: April 11, 2018

Improving workflow control in radiotherapy using discrete-event simulation.

Bruno Vieira^1,2, Derya Demirtas^3,4, Jeroen B van de Kamer⁵

¹Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands. b.vieira@nki.nl.

BMC Medical Informatics and Decision Making

|October 26, 2019

Summary

Optimizing radiotherapy scheduling with a full pull strategy improves patient timeliness, despite slightly longer waits. This approach helps more patients meet treatment targets and reduces psychological distress.

Keywords:

Discrete-event simulation Radiotherapy Resource planning Waiting times Workflow control

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Area of Science:

Oncology
Healthcare Management
Operations Research

Background:

Minimizing radiotherapy waiting times is crucial for mitigating tumor growth and patient distress.
Radiotherapy pre-treatment workflow is influenced by scheduling strategies: pull (appointment after consultation) and push (appointment after workflow completion).

Purpose of the Study:

To assess the impact of pull and push strategies on radiotherapy timeliness.
To explore interventions for improving the efficiency of radiotherapy pre-treatment workflows.

Main Methods:

Discrete-event simulation modeled patient flow in a Dutch hospital's radiotherapy department.
Model inputs were derived from staff surveys, manager interviews, and historical data (2017), accounting for patient inflow and resource variability.

Main Results:

A hybrid (40% pull/60% push) strategy showed 12% lower average waiting times and 48% fewer rebooks than a full pull strategy.
However, the full pull strategy resulted in 41% fewer patients missing waiting time targets.
Evenly spreading consultation slots reduced waiting times by 21% in the baseline case.

Conclusions:

A 100% pull strategy enables more patients to start treatment within target waiting times compared to a hybrid strategy.
The study provides an algorithm for policymakers to balance push and pull strategies for timely, patient-centered radiotherapy care.