C KEV SELL RADIATION ONCOLO y GREG
1. Executive Summary 1 ( : V C 11. Appendices 2 7. Options 17 6. Time study analysis & formulation 9 9. Potential Revenue 18 1. Recommendations 19 3. Department Operation 6 4. Methodology 7 5. Survey analysis 8 8. Bluebook standards 17 2. Introduction 5 ThLE OF CONTEN
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Purchase a new treatment unit as soon as possible so that blue book standards are maintained. The cost of technologists to ( - operate this new unit would be approximately $14. Instruct doctors to make an effort to sign patients during consultations so that the simulation wait times can be reduced. At the time of the consultation the patient is already in the department, has been assigned an examination room, and the physician is present. Eliminating the need for these conditions to be replicated at the time of the actual simulation will increase efficiency. During the time study period between 8% and 9% of the simulation wait times could have been eliminated if the patient had been previously signed. This nonproductive period represents the equivalent of over one fourth of an FTE over the course of a year.
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a
C C extremities body and patients Contour Films Fluoroscopy Take Appendix 1.1 Simulation Procedural Flow Chart and Align Immobilize no yes
Appendix 1.2: Treatment Procedural Flow Chart C Patient Treatment Setup: 1. greet patient and explain 2. position gantry, aids, and the patient Port Films: Are 1. take and es port I based on number develop films of ports to be 2. compare needed treated no I Are tbe yes Treatment: 1. chart time films 2. apply accurate? radiation no Goto simulation Cleanup schedule Patient Out
Technologists per treatmont simu lation Treatments (mm) First Basic Simu lations (mm) Total Patients Total Treatments SPVEs Ports per pahent -. 2 1 15 15 6 821 12951 21497 4.2 2. 2.5 15 15 3 862 31978 2.5 3. 3 2 2 2 15 884 12817 21456 4. 4. 3 5 2 2 6 145 21392 3555 2. 5. 2 1.5 35 15 25 164 2937 3315 2.5 6. 3 2.5 3 15 6 181 3356 3.5 7. 2 1 2 15 6 859 19193 28796 2. 8. 2.5 2 45 2 9 765 11859 2575 9. 3 2 2 1 6 266 4738 79387 5.8 1. 2 1 15 1 6 11. 1 1 6 3 6 3 341 591 4. 12. 2 2 2 1 3 12 34 59 2. 13. 2 2 3 15 6 14. 3 2 1 1 6 1268 385 5116 3. 15. 1.5 1 15 15 6 44 2. 16. 1 1 9 15 45 13483 17. 2 1 3 15 9 2 1.5 2 15 9 14 83 1 5887 2245 2.3 Source: survey Feb.-Mar. 1987
2. 2 1 3 2 9 142 321 432 2.3 19. 3 2 45 15 9 1458 22662 3.5 Treat Simu ment lation First Basic (miii) Patients Treatments SPVEs lations Total Total per (mm) Si mu Ports per patient 32. 2 1 3 15 6 624 317 31. 2 1 15 15 45 117 2713 3. 1 1 3 15 6 524 11376 2.5 29. 2 1 2 2 6 384 1572 28. 2 1 3 15 6 7. 2 2 2 15 6 1252 13484 22 5. 26. 3 2 15 1 3 992 1914 25. 2 1 1 1 6 435 1186 1865 24. 3 2 6 15 6 1642 31438 3. 23. 2 2 2 15 6 2566 49975 5712 2. 22. 2 3 2 15 6 625 15 2.5 21. 2 1 45 35 6 21 47931 4.5 Technologists Treatments peuix : urvey uata tcqflt.) 1987 Feb.-Mar. Survey Source:
Appendix 3: Simulation Data IP 2P 3P # of ports 4P 5P th simulation type student lnitai Rosim Vsim yes no wait oostj educe 1. 77 77 77 13 2. 46 46 46 3. 68 68 68 4. 5 5 5 5. 75 75 75 15 6. 57 57 57 7. 43(6) 43 43 12 8. 74 74 74 1 L 32 32 32 12 1. 7 7 7 11. 65 65 65 25 12. 48 48 48 13. 8 8 8 14. 5 5 5 15. 4 4 4 16. 45 45 45 2 17. 47 47 47 8 18. 77 77 77 2 Source: lime Study viar 1987
s. #_of_ports simulation typo student 1P 2P 3P 4P 5P th Initial Resim Vsim yes no wait 3oostl Reduce 19. 8 8 8 15 2. 57 57 57 17 21. 51 51 51 26 22. 71 71 71 3 23. 26 26 26 5 24. 127 127 127 13 25. 32 32 32 26. 57 57 57 27. 78 78 78 28 28. 132 132 132 15 source: Elm e study :eb. JI 1 I 987
. treatment type # of ports basic first I P 2P 3P 4P SP th RMS yes student no -1. 8 8 8 2. 42 42 42 3. 13 13 13 9 4. 9 9 5. 12 12 12 6. 34 34 34 7. 1 1 1 8. 53 3(8) 53.. 7 7 7 ;, 1. 17 17 17 11. 12 12 12 12. 18 18 18 13. 11 11 11 14. 9 9 9 15. 16 16 16 16. 9 9 9 17. 45 45 45 18. 13 13 13 ource: lime Study :eb V. 1987
Appendix 4: Treatment Data (cont.) treatment tvdr # of ports basic first 1P 2P 3P 4P 5P th RMS yes student no 19. 24 24 24 2. 59 59 59 21. 1 1 1 22. 34 34 34 23. 17 17 17 24. 9 9 9 25. 22 p2(6) 2(7) 22 26. 7 7 7 27. 23 23 23 28. 1 1 1 29. 6 6 6 3. 1 11 11() 11 31. 15 15 15 32. 38 38 38 33. 13 13 13 34. 1 1 1 35. 11 11 11 ource: ime tudy :eb. - 36. 13 13 13. 987
-- - # Appendix 4: Treatment Data (cont.) # treatment basic first 1 P 2P of ports 3P 4P 5P th RMS yes student no 37. 14 14 14 38. 6 6 6 39. 9 9 9 4. 6 6 6 41. 21 21 21 42. 15 15 15 43. 1 1 1 44. 7 7 7 3. 1 1 1 46. 14 14 14 47. 55 55 55 48. 35 35 35 49. 9 9 9 5. 9 9 9 51. 9 9 9 52. 1 1 1 P3 12 12 12 3ource: rime 3tudy -z 54. 41 41 41.lar. 1987
Appendix 4: Treatment Data (cont.) K treatment # of ports Woe basic first 1P 2P 3P 4P 5P th RMS yes student no 55. 8 8 8 56. 12 12 12 57. 1 1 1 58. 12 12 12 59. 9 9 9 6. 24 24 24 61. 9 9 9 62. 17 17 17..3. 11 11 11 64. 1 1 1 65. 14 14 14 66. 9 9 9 67. 14 14 14 68. 1 1 1 69. 23 23 23 7. 11 11 11 1. 19 19 19 72. 3 3 3 source: ime study :eb.4ar. I 987
Appendix 4: Treatment Data (cont..) treatment lyde #OfpOflS basic first IP 2P 3P 4P 5P th RMS yes student no 3 3 (8) 3 74. 1 1 1 75. 23 23 23 76. 17 17 17 77. 14 14 14 78. 11 11 11 79. 25 25 25 8. 1 1 1 1. 21 21 21 82. 13 13 13 83. 12 12 12 84. 9 9 9 85. 25 25 5(8) 25 86. 14 14 14 87. 13 13 13 88. 11 11 11 q9 1 1 1 9. 3ource: I ime 5tudy :eb. 1ar. 987
Appendix 5: Trend information 9 Average Films per Patient by year 7.18 7.49 6. 5.86 3. 3.76 82-83 83-84 84-85 85-86 86-87 Treatment Aids per Patient by year 5. 4. 3.79 4.21 3. 2.57 2. 1. 1.28 1.58 II I 82-83 83-84 84-85 85-86 86-87 Source:istorical data 1982-1987
25 Average Treatments per Technologist by year 2421 Appendix 5: Trend Information (cont.) 24 2376 23 227311 2173 82-83 83-84 84-85 85-86 86-87 SPVE Treatments by year 3232 3 2793 25 1 9965 2 7 17629 15 13891 82-83 83-84 84-85 85-86 86-87 Source: istorical data 1982-1987
AppendIx 5: Trend nfomatlon (cont.) Average SPVE Treatments per Patient by year 43.58 4. 38.42 35. 3. 28.82 :: 3.66 32.46 82-83 83-84 84-85 85-86 86-87 44 Average SPVE Treatments per Technologist by year 436 42 4 38 :::: ii i182-83 375 3918 3811 83-84 84-85 85-86 86-87 Source: istorical data 1982-1987
RESULTS:, 28 (rms) I of observations average of observations UM Department x Department y Surveys Appendix 6: Data Analysis of the surveys ( C Technologists per 32 2.1 2. 3. 3. Treatment Technologists per 32 1.5 1.5 2.5 2.5 length of first 32 3.1 3 2 3 treatment in minutes length of basic 32 15.6 1 5 2 1 5 treatments in minute length of simulations 32 64.5 6 6 9 in_minutes number of patients number of treatments SPVEs Ports per Patient Source: Analysis of survey information 22 2.7 2.3 2. 2.5 15 29672 32 355 27 22625 2115 21392 3358 99 821 145 18 Silat ion
Appendix 6: Data Analysis ot simulations RESULTS: Si m u I at I on s # of ports # of observatons average of observations 1 Port 8 52.6 Port 2 12 65.2 3 Port 4 6. 4 Port 3 89.7 5Port Other 1 43. C Simulation 2 66.2 Re-Sim 1 77. Vsim 6 45.3 Student: YES 19 59.5 9 59.1 Wait 28 11.7 Boost/Reduce 1 68. Source: Analysis of time study data
9 13.6 7.6 Type Basic I of observations average of observatior standard deviation Treatments RESULTS: C. Source: Analysis of time study data no 29 15.1 1.2 yes 6 12.9 5.9 Student RMS 5 5.4 3.1... Other 2 39.5 13.5 5 Port 3Port 4Port 44 12.9 5.9 2 Port 9 12.3 1.6 6 15.8 4.6 # of ports 1 1 38. Port 13 32.9 14.9 13 1.2 4.3 First ppenciix : Data inaiysis of treatments
.7324 +.1799X Y OR Direct (#weeks/months per year) = I (Techs/indirect activity) (Time/activity per week/month) Indirect Y = $ technologists required X = I new patients FORMULAT IQli C. 284Y +.5798 +.1427X = 1 After time study adjustments rewritten as: (1248 tech minutes/year) Total time = I PWT + Vacation minutes = Total time minutes ((346 days) + (31 days) (Y 1)) (48 minutes/day) = Sick/vacation (1.67) ( T + S + I ) = Paid working minutes (PWT) Combining indirect and direct After time study adjustments rewritten as: 1335.OX T (Tx tech mins) (1 + PF factor + NP factor> T (Tx mjns/unjt) (I techs/unjt) = Treatment tech minutes Tx minutes/unit (Predicted I treatments) (Avg time/treatment type) = (Time study avg) + (RMS addition) = Avg time/tx type Treatments After time study adjustments rewritten as: 33.4X = $ (Sim tech mins) (1 + PF factor + NP factor) = S (Simulation time/unit) (4 techs/unit) = Sim tech minutes Simulation time/unit (Predicted I procedures> (Average time/procedure) = Simulations (1392) (Y) + 594 = I After time study adjustments rewritten as: Appendix 7.1 Formulation
() 4. 4. Time Out: Problems: 2. 3. 2. 3. Number of Fi1m: Student: Time In: Basic Treatment: Ports: Blocks/kids: C First start end start end start end Time Treatment Ports: Blocks/kids: Name: Treatment Area: 1. 1. Appendix 8.1 : Treatment time study form Clean/Schedule/Mark: end Chart Time: start start end start end Treatment Setup Treatment Set Up Take/Develop Cozttpare Explanation Time: RMS:
3: 2: Immobilize/Align: Explanation time: Call Resident: Films-Setup and Take: 1: Call Doctor: Time in: C Nane: Treatment Area: Ports: Student: Appendix 8.2 : Simulation lime study form Time away from patient: Time Out: Problems: Call Dosimetrist: ark/clean/schedule: Polaroids: Computer log: Charts: Chart Time: Label films: Contour: Call Resident:. Call Doctor: 4:
JUNE OCT. DEC. AUG. NOV. AUG. NOV. SEPT. SEPT. JULY JULY JUNE.1.5 MRS 9.5 RS JAN. FEB. APRIL.1 R. TIMES DOWN TIMES DOWN )7. / VENDER CALLED! C I 5.5 MRS 1/5 4. MRS. 1/1 PMI 1/2 3/9 2/2 2/4 2/8 /2 TIMES DOWN TIMES DOWN VENDER CALLED/ 6/1 VENDER CALLED I MACINE DOWNTIME 1986 VENDER CALLEDZ JAN. FEB. APRIL JAN. FEB. APRIL 5. RS DEC. AUG. NOV. SIM.2 JUNE JULY OCT. DEC..5 MRS 18 1. MRS. SEPT. 1 MRS 6.75 MRS. 1/2 3.5 MRS /1 MRS 1/2 MRS /1 1/3 RUNNING 8-25 4/4 1/2 -- TIMES DOWN VENDER CALLED/ 2. MRS.2/5 1 PMI (MACMINE UP AND DOWN FIRST WEEK) /1 /1 /4 1.2.5 MRS 1/2 1 PMI /1 /2 12 MRS. 4/4CL-18 ( OCT. DUAJ : (FROST)D.T;8 3-FEB-1987 Q9:j7 Page 1 MARC MAY MARC MAY MARC MAY 1.5 MRS 2.75 MRS. 8.25 MRS. 13 MRS. 2. MRS. 3.25 MRS. -,A; i. MOVED MOVED MOVED.26 MRS /2 3. MRS 5Th. 1.25 MRS /4.5 MRS.1.5 MRS I
J)UA1 : [FROST JD.T ii 2 APR I 987 15:28 Page C MAC I NE DNT I ME 1 987 CL-IS VENDER CALLED! 6/1 VENDER CALLED! TI ME S D(3M4 T I ME S DCN JAN. 3 mm. /1 4.5 hrs. 1/2 P.M.I. FEB..75 RS 1/1 M&Rc 3 MIN. / 3 MIN / APRIL MkY JUNE JULY AUG. SEPT. ocr. NOV. DEC. 18 VENDER CALLED! SIM.1 VENDER CALLED! T IME S D(YM4 T I ME S D(YM 1 JAN. 7 days, 3 mins. asym. jaws FEB. MRC 3 DAYS, 1 OUR 1/3 ( APRIL - MY JUNE JULY AUG. SEPT. OCT. NOV. DEC. SIM.2 VENDER CALLED! TIMES D(YN JAN. FEB. M&RC APR! L MY JUNE JULY AUG. SEPT. ocr. NOV. DEC.
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL #OF #OF #OF #OF OF OF OF OF OF OF OF SCEDULED OF PATIENTS 23 26 1 26 I I 75 TOTAL ONSULTS 2 I TOTAL P32 I NTRACAVI TARY- 2 * OF RESIMS I TOT.L 12 16 3 I 1 o NEW STARTS 4 I 7 I 4 15 PATIENTS UNDER TREATMENT 18 I 26 I 22 I I 66 PATIENTS ON REST 5 I I 4 I 1 9 18 I 18 I 6/1 I ORThO I TOTAL C DATE: OCTOBER 21,1986 [From Wed. to the following Tues.] CIEF TEC. REPORT SIM I SIM 2 TOTAL PATiENTS TX D ON SATURDAY-S TEC. OUR S TO T EAT CELLS-I.5 OUR S CELLS-2 NOT 32] NEW PAT I ENTS ml S {)NT- 46 [LAST WEEK TERE WERE ONLY 31, FOLLCW-UPS=2 I AFTER OUR CALL-INS- TOTAL TOTAL # TOTAL TOTAL # EYE PLAQUES- INTERSTITIAL= OF SIMS. BILLED FOR * OF NEW SIMJLATIONS TOTAL # OF TREA1MENTS 94 I 118 116 I 1328 DR. DIAZ S PATIENTS 6 I I I 16 I I 23 # T.I.D. PATIENTS I I I DR. LICTER S PATIENTS 8 I 13 I 4 I I 25 # B.I.D. PATIENTS 2 I I I 2 M&C 1 NE D(YNT IME I I I I # M4C I NE START S I I I I I 2 o DR. PEREZ TAMkYO S PATIENTS 9 1 12 6 1 27 DUA1 : [FROST]CTR..13 22 OCT--1986 9:47 I I 13 I 28
I 1A11 16 86-67 PT1EN1 C9& C, 1 1k1ZA11X D_INIC VISITS S1?U..ATt LOCk.IZATIO6 IE 6/l 1, tho, Cc 6 1 air M STItLATIX I I I I I i I, I I I I I I I I I I Date [w :flat:s1ts 1 TIC*6 IFIELDS S1 TAU fleld 9.LTS IFS I I hi I II DI : : 1 1, o: 1 vi 2 2 OI 41 21 1 Dl 1 I O II bi 31 4 3 61 1 OI 1 I II 11 61 6 4 31 11 Cl : 1 1 Ii L 3: 2 I ni O, Al 5 4: 1 O OI i: o: o: : 21 11 5 I A I I II 6 1 1 O v1 3, 1 1 1 4 I Al : o: : 1 1 1 Dl 1 v, 1 I Al a 1 1, Vi O o: 1 o: : 1 o: 1 I 41 Al 1 1: o: 1 2: 31 1 3 3 I Al 1 4: 21, 1l o: 1: o: : 1 81 91 5 I II 11 21 21 o Dl a: o: 1: a: o: a: 4: Al I ii : 21 1 : 9: 11 12 I I I 13 5 LI OiI LI I 1 O 11 5: 3 14 1 : o: Oi 1 1 1 ; 1 1 1 i L I VI Ii I Al 15 1 : Dl a o: a: a: a: DI v o: Ol 16 5 t I I i I I a II 1 1 ; 1, 31 2 I I I Al 17 5 2 O 1: 1 11 o: o. I I 18 3: a: a: 1 1 : a: o: a: 1 51 3 11 7 19 11 21 D i O, o: : 1 5: a I II 2 11 2: 1 1 1 a: a: 3: 2 I Al 21 1 1 1 V Ol a: a: o: o: : a: o: a : : 1 1 1 1 1 1 1 : 23 2: 1 I. I i : a: a: I ;. Al I 11 7 II I 24 3: : : 1 1 1 ; 1 I I I lii 5 51 1 Dl : Dl O 1 6 61 2 2b 4: I II I ii, I II D Dl 1 o 41 4 27 1 I I I 1 II 4 Cl : 1 l 4, I 4 I Al Dl 1 : 1 1 Dl D 1 VI 1 I Al 29 Dl 1 : 1 : 1 v, Dl I II II çi l 21 : 1 Li I 1 L 1 I OiI I Al 4 31 3: 3 1., 1 1 1 1 9: a l I I I I I I I I, _...,_i I I I I I I I I I I OflLYiDTcL 651 18; 112 19: 91 2: Cl 911 3 I I I I I I I I I 1 I I I I I I I I i I I I YThIUTAL 518: 1 :162: 43212: 77: 81 5 96,261 9481 869 II 7t.V CAS YTO 1t1 CAKE 616 -CCASES
I TAT?DTS #tzport$, 1 1LY TATENtS OT R TAflNT 1S I P2 ( kte :PTS1PTS:PATSPA1 PR PRT1PRTSPATS1PRT51PTS :1I11flS:18O 18 :6I1TC:C 861? P*UENT WGL 1 1 I 1 1T1. 1 18 1 II tluim. I IRC 1 I 1 1 1 1 1 1 1 1 1 1 IE T:FCTON:I 1E TR:P1C1I 18 :1rIP1IE1AI! I 1 o a: ::1:: 11 o:o:o:o:o:o: 1 a: a a: a: a: 2 31 23: 23: 51 121 171 17: 1 1 571:1: 1: 1 : 36: 37: 1 I Aj 3 4 261 26 51 13 ill 161 1 v 59 2U1 o:o: : a: io 391 : o: I IC 4 i: : : 41 12 151 a: a: : o: : a: a: a; a: 61 681 331 34: Dl 5 61 231 : 5: 14: 191 191 1 U 631: a: a: 1,. U 66 4 I 4. a: 6 61 1 271 31 151 18 1 U U 67: U U U U U 1 U 74 371 Sil U I I 7 a 1 O14;4 A, 11 6111111 U U 2 81 21 1 I Al 8 a a: a: a: o:o,. a: a: o:o:o:o:o:a: a: a: a : U a: 9 A 6:2:24:3111:14123:, V 6111:111161 61 : 54: a: 1 6 21 24 3 151 18 21 U 1 631 a: a: U U U U 6 62, 361 s: : 11 4: 11121 1171l7 :1 59:1::11111 44 34: 34: U 12 5: 21 211 31161191 1 11 as;o:o:o:o:o:o; 1 461 411 611 1 13 41 231 24 8 l 311 36 1 U 91 U U U U U U 1 73 i 691 U I, I 14 II 1 1,, 7 i 11 81U1 U 1 121 11 U I AS 15 a a: a: o:o:o: : : o:a::o:o:oiv.o: o a: a: a: 16 UDI 1?3134 411 1 1 75: UOU 74: 971 a: 17 A U 1 :4:31133:411, v 74U U 76 1 : 18 O UO 41 :311 361 1: 67:OUQ::: 77: 8U 1 19 31211241 3 U U?6I2OUOUO U. 4e1 6Q1 U 2 4: 231 241 3: 1 : 331 Dl 1 : ::: 11 11 U 73 5 141 1 I Al 2.1 a: a: a: a: a: a: 41 1 4:o:o1::o:o:1 1 91 1 23 3 261 27 31 211 26 31: 1 : 941 1:: ô1 a; U 79 51 77 U I Al I Al 24 3 26: 21 3 1 : 3 v. 82 U11. v 1 79 5 79; 1 3 21 23 3 2 23 26 U U 72 UGI UU 1 1 oo 45: 61 U 26 4 2 1 26 U o: 79:11111 U 1 79 511 64 U V 4 211 31 21 231 1 27 : 1 821 111 :1 a; U 83 S 671 1 I II 3 1 291 31 231 26: 261 1 1 81:1 11 11 U U 78 54; 631 : 31 3:3 2:2426 I Li I U 84111:1U 81 1 66 a: I Al I I I S I I I I I I I I I I I I I I I II U I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I II r1ptttc.. 8314,6995163312,878:3177:5162 II?:13,51:: 2113: 2:1, i.2?i112799:7,116l,829 1 Al I I I I I I I I I I I I I I I I I I I I, U U :1: U 1 U OOOUOOUO U 1 1 U a: a: a: o, 11 1 1 1 11 : a: : 1 VI 1 U 2: 1 a: U U :212: U ; U 2111 U 31 : U P1ATi NX
DEPARNE1 RADIATiON ONCOLOSY ISTORICAL SP1TL PROCEDUR(5 DATA C FEE 82-83 83-84 84-85 85-86 86-87 DESCRIPTION CODE I I - Follow up clinic visit extended 1831 1 1 1 Follow up clinic visit intermediate 1833 1 1 1 1 1 3 1 Follow up clinic visit - brief 1835 68 1 647 745 1 189 1 596 Teleradiotherapy consult.tion extended-lnpatient only 18351 16 1 192 87 1 31 1 IC Teleradiotherapy consultation-intermediate 18353 649 1 577 1 162 1 19 1 693 Teleradiotherapy consultation brief 18355 56 1 5 79 82 1 65 leteradiotherapy consultation no charge 18359 3 1 23 9 1 43 1 23 Treatment plan (inclusive of procedures 7616 67636) 184 482 575 1 615 1 727 1 Patient contour localization of internal structures 1841 3 1 1 129 1 35 1 12 Setting of treatment port (per port) 1842 1131 1528 1 1713 1 262 1 Simulator aided field setting-simple 1843 25 1 158 143 1 276 1 22 S Simulator aided field setting interiediate 1844 269 1 273 1 31 1 377 Simulator aided field setting-complex 1845 129 1 226 1 432 1 716 Central axis depth dose computation 1841 913 1 127 1 1418 1 357 1 2c Isodose plan (1 or 2 beams) 18411 47 66 1 65 12 Isodose plan intermediate (3 or more beams) 18412 27 1 24 75 1 91 1 11 Isodose plan complex 18413 63 18 1 228 1 49 1 295 Isodose plan - wedge fields 18414 29 1 14 1 79 1 172 1 123 Isodose plan arc fields 18415 2 1 3 1 17 1 18 1 5 Isodose plan rotation fields 18416 2 1 1 1 3 -! dose plan moving strip fields 18417 1 1 1 2 1 33.odose plan - isocentric (additional) 18418 1 256 653 1 758 Tissue 6 geometric inhosegeneity correction (addtiona1) 18419 2 1 313 1 136 1 92 Tissue I electron beam (additional) 1842 114 1 139 1 121 1 181 1 162 Tissue I special beam consideration (additional) 18422 11 1 3 1 15 1 3 1 3 Treatment planning interpretation of special testing 18423 1 1 1 1 1 Daily treatment management simple 1843 897 1 776 712 1 465 1 631 Daily treatment management intermediate 18431 4516 1 5899 1 6775 1 6766 1 45? Daily treatment management complex 18432 311 1 42 1 4545 1 8658 1 7319 Treatment port verification films Is needed 18433 158 1 2161 1 362 1 5217 1 3668 Daily transvaginal external radiation 18434 1 4 1 1 6 1 1 Daily per oral external radiation treatment 18435 1 1 1 1 Daily superficial external radiation treatment auxilia 18436 1 1 1 1 1 Daily orthovoltage external treatment 18437 1 1 1 1 Weekly treatment management - simple 18438 1 1 1 Weekly treatment maragement intermediate 18439 1 1 1 1 1 2 1 Weekly treatment management - complex 1844 1 1 1 4 1 Irradiation of body fluids/tissue 18442 32 1 358 1 638 439 2 Treatment Planning - Simple 18444 1 67 Treatment Planning - Complex 18445 1 1 1 1 92 ltiplanar 3 C Treatment Plan, Addl 18446 1 1 1 1 1 ultiplanar CT Treatment Plan Addl 18447 1 1 1 1 46 Isodose Plan ultiplanar 3-, AddI 18448 1 1 11 Isodose Plan ultiplanar Cl, Addl 18449 1 1 1 4ge filter design and fabrication 1845 45 1 66 173 1 281 1 us design and fabrication 18451 33 1 37 56 1 Th 74 Field block design and fabrication 18452 464 73 1 1249 1 2228 1 1625 Compensation filter design and fabrication 18453 2 15 3 3 oldc or casts for immobilization 18454 9 13 1 7 1 56 1 1 1 I I
3 45 26 1 46 1 13 59 1 27 32 : 46 1 26 1 1? 8 1 24 29 18 24 33 1 36 16 A I A I A I I, I Id I V 19 1 19 1 24 1 11 A I A I A I V V V I 23 1 44 6 I 2 61 33 36 2 13 1 17 1 19 12 CONSULTS AND FOLLOW-UPS - NSP ONLY 1,359 1 1,49 1,83 1 2,338 1 1,496 OSPITAL PROCEDURES 14,73 1 18,672 1 24,88 1 36,481 1 26,888 TREATNENTS 8,523 1 1,691 1 12,36 1 15,925 1 12,8 AVERASE TREATMENTS PER PATiENT 17.68 1 18.59 1 19.57 1 21.91 1 24.51 F1LRS 1,58 1 2,161 1 3,62 1 5,217 1 3,668 AVERABE FiLMS PER PATIENT 3.28 1 3.76 1 5.86 7.18 1 7.49 TREAThENT PLANNING 3,427 1 4,148 1 5,929 11,117 1 8,4Th TREATMENT PLANN1NS PER PATIENT 7.11 1 7.21 1 9.64 15.29 1 17.29 TREATMENT AIDS 619 1 97 1 1,583 I 2,758 I 2,63 TREATMENT AIDS PER PATIENT 1.28 1 1.58 1 2.57 1 3.79 1 4.21 NUMBER OF TECNOLO6ISTS ON TREATMENT UNITS 3.75 1 4.5 1 5.63 1 7.33 1 1.44 19 193 233 1 186 14 82-83 1 83-84 1 84-85 1 85-86 1 86-87 Stents r bite blocks 18455 3 infusion of radioactive saterials far therapy 18468 1 Application done by SYN service, supervision of rid ther 18469 1 Rathatior therapy after hours 1849 134 1 dius dosimetry and interpretation of application 1846 35 1 Continuing physics charge 18486 1 TLD or aicrodossetry 18485 6 Radioisotope dosimetry and interpretation of application 18461 12 1 Radioisotope handling & loading (included in 1665,7666,7 18481 12 Radius handling and loading (included in 7667 7669) 1848 1 Cost of providing radio-element; gold seeds 18475 1 1 Cost of providing radio element; strontium 18477 1 1 Cost of providing radio-element; irridius 18478 8 Cost of providing radio decent; cesium 18479 1 Cost of providing radio-element; iodine seeds 18476 4 Interstitial radius application 18472 1 Interstitial radioisotope application 18473 12 Intracavity radius application 1847 37 Intracavity radioisotope application 18471 1 1 rsternal coapensating shield for radioisotope sources 18457 3 1 Etirna1 coepentng shield 4or radius sources 18456 35 I 2 3 1 31 3 A I I A I V I V I V 31 1 45 26 16 31 3 2 I A I V I i I V I 24 1 29 1 33 I 18 6 13 1 9 1 4 o : 1 1 o 464 1 672 1 515 184 1 278 1 135 1 24 I I I I I I I I TOTAL PROCEDURES 16,89 1 2,162 1 26,611 1 38,819 1 28,384 Total ports (per census reports) 29,299 tv 2 1t LIC
AVERA6E TREAThENTS PER TECNOLOGIST 2,272.8 2,375.76 2,t3?.83 2,172.58 2,42.97 (VERA6E FI1S PER TECNOLOGIST 421.33 1 48(.22 639.79 1 711.73 739,52 AVERABE TREAThENI AIDS PER TECNOLOGIST 165.7 21.56 281.17 1 376.26 415.93 SPVE TRERThENTS 13,891 1 17,629 19,965 1 27,93 1 32,32 AVERAGE SPVE TREATNENTS PER PATIENT ii 28.82 3.66 1 32.46 38.42 43.58 AVERA6E SPVE IREAThENTS PER TECNOLOSIST a 3,74.27 1 3,917.56 1 3,546.18 1 3,81.37 1 4,35.38 Through February a 87-87 ii prorated to year and OPSREVI C:\I23FILES 3/24/87 ( (.
The University of Michigan Medical School February 19, 1987 Stanford University Medical Center 3 Pasteur Drive Stanford, CA 9435 Dear Sir/Madam In an effort to determine appropriate staffing levels for Radiation Oncology technologists at The University of Michigan ospitals, we are conducting a study of our current departmental demands and resources. This will include an effort to obtain information from a number of peer institutions on their recent treatment volume, number of treatment units, procedures, and so on. Enclosed is your copy of a survey which we hope will enable us to assess current norms for radiation therapy departments across the country. We have also included a list of the institutions to which this survey is being sent. We ask that each department s chief technologist or an appropriate person complete the survey and return it as soon as possible. (At the latest 3/16/87.) We will send to each responding institution the results of the survey when we have arrived at the results and conclusions. Please be informed that all responses are completely confidential. Though we feel each question to be important, you may decline to answer any question. If certain information is unavailable, please estimate and indicate that your response is an estimation. Any and all information which you provide is greatly needed and appreciated. If you have any questions, feel free to contact me at (313) 936-4291. Thank you for your time and effort. Sincerely, Kathy Frost, Chief Technologist Nathan arris, Student Engineer Kevin Sell, Student Engineer Greg Randall, Student Engineer End. - - - -.----- Aoir,crI, 11 14 flfl
assignments? 2. ow many FTE tecnnologists(not including the chief technologist) do you 3. ow are these technologists distributed among the units and other employ in your department? 1. List your treatment and simulation units. ospital/organization Name: Survey Questions: Phone $: Title: Name: ( General Information: Appendix 1.2 : Survey form
Immobilization: Simulation: Subsequent treatments: First treatment: below? 11. ow much time do you schedule for each patient per tre :ment type listed If so, about how long does it take? If so, about how much time does this add to patients 9 Do technologists perform a morning quality assurance check U MONDAY TUESDAY WEDNESDAY TURSDAY FRIDAY SATURDAY 7. Are resident doctors utilized? 6. Are you a teaching facility? If so, during what hours? 5. Do you have technologists on call? 1. DQ you utilize computerized record and verification on treatment units? treatment? year? 4. ow many vacation and sick days is each technologist allotted per 8. For the corresponding days list what hours treatments are conducted. Appendix 1.2 continued
15. Approximately, how much time per technologist per month is spent in Average FTE technologists Average Ports/Patient Total Treatment Aids Total treatments Total Films Taken Total Procedures New patients -Complex treatments Intertnediate treatments Simple treatments 86 &7 84185 85 86 14.Do you conduct periodic department port film review? how often? 13. Do you conduct periodic chart checks? If so, how often? C you conduct periodic port film checks? 12. Do Appendix 1.2 continued for each of the categories listed. 16. For the fiscal years listed below please supply the corresponding data iriservice attendence? If so, how often? If so,
C Edward ines Jr. VA ospital 5th Avenue & Roosevelt Rd. ines, IL 6141 Michael Reese ospital and Medical Center 29 South Etlis Avenue Chicago, IL 6616 Joint Center for Rad. Therapy SO Binney Street Boston, MA 2115 Presbyterian-University ospital 23 Lothrop Street Pittsburgh, PA 15213 Allegheny General ospital School of Radiation Therapy and Nuclear Medicine 32 E. North Street Pittburgh, PA 15212 Good Samaritan ospital 133 E. McDowell Road Phoenix, AZ 856 Los Angeles County University of Southern California Medical Center 12 N. State Street Los Angeles, CA 933 St. Joseph ospital Medical Center Buena Vista At Alameda Burbank, CA 9155 Penrose Cancer ospital 2215 N. Cascade Colorado Springs, CO insdale Sanitarium & ospital 12 N. Oak Street insdale, IL 6521 I
Chicago, IL 6611 2 Palo Alto, CA 9431 26 6th Street, SW 3 omer Avenue Canton, OK 4471 Palo Alto Medical Clinic Salt Lake City, UT 84132 234 Goodman Street 5 N. Medical Drive University of Virginia Medical Center University Medical Center Roanoke, VA 2433 Belleview & Jefferson Street Philadelphia, PA 19111 Central & Shelmire Avenues American Oncologic ospital Fox Chase Center Cincinnati, O 45267 Cincinnati General ospital Aultman ospital Roanoke Memorial ospital St. Louis, MO 6311 Jefferson Park Avenue 51 S. Kingshighway Mallinckrodt Institute of Radiology Baltimore, MD 2125 61 N. Broadway Charlottesville, VA 2291 The John opkins ospital Superior & Fairbanks Court, - Radiation Therapy Center Wesley Pavilion Northwestern emorial ospital
3 Morgantown, WV 2656 West Virginia University Medical Center Rockford, IL 6111, 14 Charles Street 2278 University ospitals. Inc. Stanford, CA 9435 C 3 Pasteur Drive Stanford University Medical Center Norfolk, VA 2357 6 Gresham Drive Medical Center ospitals San Antonio, TX 78229 445 Medical Drive Cancer Therapy & Research Center Ft. Worth, TX 7614 145 8th Avenue Moncrief Radiatinn Center Charleston, SC 29425 171 Ashley Avenue Medical University of South Carolina Syracuse, NY 1321 ( 75 E. Adams Street SUNY Upstate Medical Ctr. Little Rock, AR 72115 P.O. Box 5668 Markham & University Central AR Radiation Therapy Institute Portland. ME 412 22 Bramhall Street Southern Maine Radiation Therapy Institute New aven, CT 651 789 oward Avenue Yale-New aven Medical Center Swedish American ospital
4 Boston, W% 2114 Walter Reed Army Medical Center Massachusetts General ospital arper Grace ospital Washington, DC 27A Washington, DC 237 399 John R St. 38 Reservoir Rd., NW Medical College of Virginia Department of Therapeutic Radiology Georgetown University Medical Center New York, NY 121 1275 York Avenue 2799 W. Grand Blvd. enry Ford ospital Richmond, V 23298 Memorial Sloan-Kettering Cancer Center San Francisco, CA 94143 University of California, San Francisco Boston, M 2111, 171 Tufts New England Medical Center Box 58 arrison Avenue Toledo, O 43699 Portland, O 97225 Medical College of Ohio 3rd and Parassus ( 925 Sw Barnes Rd. St. Vincent ospital Detroit, MI 4821 Detroit, MI 4822
5 Milwaukee, WI 53226 87 W. Wisconsin Ave. Roswell Park Memorial Swedish ospital Tumor Clinic Medical College of Wisconsin Seattle, WA 9814 New aven, CT 651 Chicago, IL 6637 Box 44 5841 S. Maryland University of Chicago Radiation and Medical Research Center Buffalo, NY 14263 University of Nebraska Medical Center Cleveland, O 4416 42nd and Dewey Ave. 95 Euclid Ave. Educational Foundation Cleveland Clinic Philadelphia, PA 19143 531 Cedar St. Mercy Radiation Therapy Center Ft. Worth, TX 7614 1425 Enderly Place East Omaha, NE 6815 Monmouth Medical Center Michael Reese! Department of Therapeutic Rad. Yale University C Royal Oak, MI 4872 3 Second Avenue 361 W. 13 Mile Rd. 333 Cedar St. 666 Elm Long Branch, NJ 774 1221 Madison St. Department of Radiation OncoloQj Beamount ospital
6 Nashville, TN 37232 Garland & 21st Ave. Division of Allied ealth Vanderbilt University ospital ouston, TX 773 Washington, DC 21 45 ilgard Ave. UCLA Center for ealth Sciences St. Vincent s Medical Center One Baylor Plaza Chicago, II 6612 6th and College St., NW oward University Jacksonville, FL 3223 P.O. Box 2982 1753 W. Congress Parkway St. Luke s Medical Center 18 Barrs St. Rush-Presbyterian College of Medicine Rochester, MN 5595 Baylor College of Medicine Desk R Los Angeles, CA 924 Mayo Clinic surveyli St