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Workflow Analysis for Framed Gamma Knife Treatments

J Liu*, E Calugaru, J Chang, Northwell Health, Lake Success, NY


(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose: To study the time required for framed Gamma Knife patients to complete treatment, identify the steps that delay treatment delivery and improve the workflow efficiency and patient experience.

Methods: A typical Gamma Knife workflow for framed patients consists of the following five steps: (1) frame placement; (2) brain MRI scan; (3) target(s) contouring by the oncologist and/or the neurosurgeon; (4) treatment plan development and approval; (5) treatment delivery. In this study, we examined the treatment process for 16 framed Gamma Knife treatments. For each treatment, multiple time points during the process were recorded including patient’s check-in time, time when MRI is completed, plan approval time, the time when the treatment started, and ended. Time interval for each step was calculated and analyzed to identify factors that slowed down the treatment workflow.

Results: On average, it took 2.7 hours from patient check-in to MR imaging completion with the longest time of 3.5 hours. Then it took an average of 1.5 hour to develop and approve a plan. After plan approval, the waiting time for patient to start treatment varied from 8 minutes to 2.7 hours with an average of one hour. The planned treatment time varied from 15 minutes to 2.5 hours with an average of 1.1 hours. The total time in hospital before treatment completion varied from 4 hours to 8.7 hours with an average of 6.25 hours.

Conclusion: Most Gamma Knife patients in this study required more than 6 hours to complete the treatment, which is a quite long time, particularly for patients in poor conditions. The entire team should work together more efficiently to shorten the process time including frame placement, MR imaging, and plan development. The long waiting time can be shortened by better scheduling to improve the patient experience.


Gamma Knife


IM/TH- Formal Quality Management Tools: Root Cause Analysis

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