ArticleBMC medical informatics and decision making2019
Improving workflow control in radiotherapy using discrete-event simulation.
Article in BMC medical informatics and decision making, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Patient-level simulation models in cancer care: a systematic review.Frontiers in public health · 2025Pooled it
- Simulation as a tool to model potential workflow enhancements in radiotherapy treatment pathways - A systematic review.Journal of applied clinical medical physics · 2023Pooled it
- Longitudinal evaluation of workflow optimization in radiotherapy: A 4-year retrospective study.Journal of applied clinical medical physics · 2025Article
- Evaluating the impact of COVID-19 protection measures and staff absence on radiotherapy practice: A simulation study.PloS one · 2025Article
- A systematic review of simulation methods applied to cancer care services.Health systems (Basingstoke, England) · 2024Review
- Automated data extraction tool (DET) for external applications in radiotherapy.Technical innovations & patient support in radiation oncology · 2023Article
- Simulation and evaluation of increased imaging service capacity at the MRI department using reduced coil-setting times.PloS one · 2023Article
- Evaluation of direct-to-angiography suite (DTAS) and conventional clinical pathways in stroke care: a simulation study.Journal of neurointerventional surgery · 2022Observational
- Bibliometric analysis of cancer care operations management: current status, developments, and future directions.Health care management science · 2022Review
- Applying Discrete Event Simulation to Reduce Patient Wait Times and Crowding: The Case of a Specialist Outpatient Clinic with Dual Practice System.Healthcare (Basel, Switzerland) · 2022Article
- Resource management framework using simulation modeling and multi-objective optimization: a case study of a front-end department of a public hospital in Thailand.BMC medical informatics and decision making · 2022Article
- Resource planning principles for the radiotherapy process using simulations applied to a longer vacation period use case.Technical innovations & patient support in radiation oncology · 2021Article
- Radiotherapy treatment scheduling: Implementing operations research into clinical practice.PloS one · 2021Article
- Radiotherapy treatment scheduling considering time window preferences.Health care management science · 2020Article
- Customizing Treatment Scheduling Windows with a Time Margin Recipe: A Single-institutional Study.Journal of medical physicsArticle
- Forecasting Institutional LINAC Utilization in Response to Varying Workload.Technology in cancer research & treatmentArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn radiotherapy, minimizing the time between referral and start of treatment (waiting time) is important to possibly mitigate tumor growth and avoid psychological distress in cancer patients. Radiotherapy pre-treatment workflow is driven by the scheduling of the first irradiation session, which is usually set right after consultation (pull strategy) or can alternatively be set after the pre-treatment workflow has been completed (push strategy). The objective of this study is to assess the impact of using pull and push strategies and explore alternative interventions for improving timeliness in radiotherapy.
methodsDiscrete-event simulation is used to model the patient flow of a large radiotherapy department of a Dutch hospital. A staff survey, interviews with managers, and historical data from 2017 are used to generate model inputs, in which fluctuations in patient inflow and resource availability are considered.
resultsA hybrid (40% pull / 60% push) strategy representing the current practice (baseline case) leads to 12% lower average waiting times and 48% fewer first appointment rebooks when compared to a full pull strategy, which in turn leads to 41% fewer patients breaching the waiting time targets. An additional scenario analysis performed on the baseline case showed that spreading consultation slots evenly throughout the week can provide a 21% reduction in waiting times.
conclusionsA 100% pull strategy allows for more patients starting treatment within the waiting time targets than a hybrid strategy, in spite of slightly longer waiting times and more first appointment rebooks. Our algorithm can be used by radiotherapy policy makers to identify the optimal balance between push and pull strategies to ensure timely treatments while providing patient-centered care adapted to their specific conditions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.