Staffing Levels and Workload for Radiation Therapists in Canada

Giddings, Alison; Nica, Luminița; French, John; Davis, Carol-Anne; Smoke, Marcia; Bolderston, Amanda

doi:10.1016/j.jmir.2018.12.003

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…This included strategies documented elsewhere [ 9 , 47 ], such as embedding aspects of relational care into other tasks, for example, much of the discussion about wellbeing occurred while the nurse was preparing the patient to receive chemotherapy. These pressures, of course were observed to impact other professional groups working in the clinics too, and it is noted that there is considerable variability in staff patient ratios for outpatient cancer care [ 50 – 54 ].…”

Section: Discussionmentioning

confidence: 99%

The complexities, coordination, culture and capacities that characterise the delivery of oncology services in the common areas of ambulatory settings

Easpaig

Tran

Winata

et al. 2022

BMC Health Serv Res

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Background Relatively little is understood about real-world provision of oncology care in ambulatory outpatient clinics (OPCs). This study aimed to: 1) develop an understanding of behaviours and practices inherent in the delivery of cancer services in OPC common areas by characterising the organisation and implementation of this care; and 2) identify barriers to, and facilitators of, the delivery of this care in OPC common areas. Methods A purpose-designed ethnographic study was employed in four public hospital OPCs. Informal field scoping activities were followed by in-situ observations, key informant interviews and document review. A view of OPCs as complex adaptive systems was used as a scaffold for the data collection and interpretation, with the intent of understanding ‘work as done’. Data were analysed using an adapted “Qualitative Rapid Appraisal, Rigorous Analysis” approach. Results Field observations were conducted over 135 h, interviews over 6.5 h and documents were reviewed. Analysis found six themes. Staff working in OPCs see themselves as part of small local teams and as part of a broader multidisciplinary care team. Professional role boundaries could be unclear in practice, as duties expanded to meet demand or to stop patients “falling through the cracks.” Formal care processes in OPCs were supported by relationships, social capital and informal, but invaluable, institutional expertise. Features of the clinic layout, such as the proximity of departments, affected professional interactions. Staff were aware of inter- and intra-service communication difficulties and employed strategies to minimise negative impacts on patients. We found that complexity, coordination, culture and capacity underpin the themes that characterise this care provision. Conclusions The study advances understanding of how multidisciplinary care is delivered in ambulatory settings and the factors which promote or inhibit effective care practice. Time pressures, communication challenges and competing priorities can pose barriers to care delivery. OPC care is facilitated by: self-organisation of participants; professional acumen; institutional knowledge; social ties and relationships between and within professional groups; and commitment to patient-centred care. An understanding of the realities of ‘work-as-done’ may help OPCs to sustain high-quality care in the face of escalating service demand.

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Section: Discussionmentioning

confidence: 99%

The complexities, coordination, culture and capacities that characterise the delivery of oncology services in the common areas of ambulatory settings

Easpaig

Tran

Winata

et al. 2022

BMC Health Serv Res

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“…For these reasons, workforce models cannot be solely based on population estimates or cancer incidence, historic levels of staffing or funding, or number of treatments delivered 18,19 and need to be reviewed frequently to keep up to date with treatment changes. 20 Models also need to factor in essential non-clinical activities carried out in radiation oncology services that are not directly linked to patient care. 19,21 Robust workforce models are needed for workforce planning to ensure sufficient investment is made in training, recruitment and retention efforts to meet future demand for services.…”

Section: Introductionmentioning

confidence: 99%

“…A key consideration for these models is how to account for new and more complex treatment techniques that disproportionately increase workload. For these reasons, workforce models cannot be solely based on population estimates or cancer incidence, historic levels of staffing or funding, or number of treatments delivered 18,19 and need to be reviewed frequently to keep up to date with treatment changes 20 . Models also need to factor in essential non‐clinical activities carried out in radiation oncology services that are not directly linked to patient care 19,21 …”

Section: Introductionmentioning

confidence: 99%

Using national data to model the New Zealand radiation oncology workforce

et al. 2022

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Introduction Demand for radiation therapy is expected to increase over time. In Aotearoa/New Zealand, the radiation oncology workforce experiences high numbers of clinical hours but an intervention rate that is lower than in comparable countries, suggesting unmet treatment need. Accurate models on the supply and demand for radiation oncologists (ROs) are needed to ensure adequate staffing levels. Methods We developed a demand model that predicted the future number of ROs required, using national data from the Radiation Oncology Collection (ROC) and a survey of ROs. Radiation therapy intervention and retreatment rates (IR/RTRs), and benign and non‐cancer conditions being treated, were derived from the ROC and applied to Census population projections. Survey data provided definitions of treatment by complexity, time spent in different activities and time available for work. Results were linked to radiation oncology workforce forecasts from a supply model developed by the Ministry of Health. Results The demand model showed that 85 ROs would be needed in 2031, if current IR/RTRs were maintained, an increase from 68 in 2021. The supply model predicted a decrease in ROs over time, leaving a significant shortfall. Model parameters could be modified to assess the impact of workforce or practice changes; more ROs would be needed if average working hours reduced or IR/RTRs increased. Conclusion Workforce models based on robust data collections are an important tool for workforce planning. The RO demand model presented here combines detailed information on treatment and work activities to provide credible estimates that can be used to inform actions on training, recruitment and retention.

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Current status of the working environment of brachytherapy in Japan: a nationwide survey-based analysis focusing on radiotherapy technologists and medical physicists

Kojima,

Okamoto,

Kurooka

et al. 2024

Journal of Radiation Research

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Brachytherapy (BT), especially in high dose rate (HDR), has become increasingly complex owing to the use of image-guided techniques and the introduction of advanced applicators. Consequently, radiotherapy technologists and medical physicists (RTMPs) require substantial training to enhance their knowledge and technical skills in image-guided brachytherapy. However, the current status of the RTMP workload, individual abilities and quality control (QC) of BT units in Japan remains unclear. To address this issue, we conducted a questionnaire survey from June to August 2022 in all 837 radiation treatment facilities in Japan involving RTMPs. This survey focused on gynecological cancers treated with HDR-BT (GY-HDR) and permanent prostate implantation using low-dose-rate BT (PR-LDR). The responses revealed that the average working time in the overall process for HDR varied: 120 min for intracavitary BT and 180 min for intracavitary BT combined with interstitial BT. The QC implementation rate, in accordance with domestic guidelines, was 65% for GY-HDR and 44% for PR-LDR, which was lower than the 69% observed for external beam radiation therapy (EBRT). Additionally, the implementation rate during regular working hours was low. Even among RTMP working in facilities performing BT, the proportion of those able to perform QC for BT units was ~30% for GY-HDR and <20% for PR-LDR, significantly lower than the 80% achieved for EBRT. This study highlights the vulnerabilities of Japan’s BT unit QC implementation structure. Addressing these issues requires appropriate training of the RTMP staff to safely perform BT tasks and improvements in practical education and training systems.

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Staffing Levels and Workload for Radiation Therapists in Canada

Cited by 3 publications

References 12 publications

The complexities, coordination, culture and capacities that characterise the delivery of oncology services in the common areas of ambulatory settings

The complexities, coordination, culture and capacities that characterise the delivery of oncology services in the common areas of ambulatory settings

Using national data to model the New Zealand radiation oncology workforce

Current status of the working environment of brachytherapy in Japan: a nationwide survey-based analysis focusing on radiotherapy technologists and medical physicists

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