A service line approach: Using whiteboard analytics to improve time efficiency in radiation oncology

The purpose of this study was to develop and implement a custom-designed electronic workflow management tool created by Medlever, Inc, in order to improve efficiency, leverage interoperability and maximize overall labor resources. Administrators and clinicians from five Banner MD Anderson Cancer Center, Department of Radiation Oncology clinics utilized Medlever, Inc. to track and analyze clinical workflow. Real-time data were collected for the duration of 3 months. Time and process data were compared month-to-month from each of the five Banner MD Anderson facilities. The data were quantified based on efficiency scores, where efficiency score was defined by measured timelines for work completion, which was defined by average measured times to complete clinical process steps. The overall average efficiency score for the clinical process steps were as follows: simulation - 66%, define target volume - 69%, creating a treatment plan - 71%, plan review - 76%, finalizing plan - 81%, physics review - 73%, IMRT QA - 72%, approving treatment plan - 69%, and therapy chart check - 66%. The combined average efficiency scores for facility A through E were approximately 72%, 77%, 82%, 66%, and 60%, respectively. Overall, the average sum of all clinical efficiency scores for the radiation oncology service line for all five facilities was approximately 73%. The results set the base line for efficiency and can be evaluated in future studies. In conclusion, a workflow management tool is an effective system to provide results for real-time data tracking, opportunities of improved efficiency, and evidence-based approaches to workflow decision making.