Optimization of Patient Care Flow in a Radiotherapy Service using the PDCA Cycle

Authors

DOI:

https://doi.org/10.29384/rbfm.2025.v19.19849001845

Keywords:

PDCA Cycle, Operational Efficiency, Management, Quality Tools, Radiotherapy

Abstract

This study explored the application of the PDCA Cycle (Plan, Do, Check, Act) to optimize the patient care workflow in a radiotherapy service, focusing on efficient scheduling and execution of sessions on linear accelerators. Prior to the study, the service faced workload overload issues with significant delays, especially in the afternoon and evening periods. The methodology included the standardization of routines, definition of performance indicators, and restructuring of the schedule based on the actual capacity of the equipment, adjusting the average times by type of treatment. In the implementation of the PDCA Cycle, quality management tools were used, i.e., brainstorming, 5 Whys, Ishikawa diagram, and control charts. The results showed a significant reduction (p<0.05) in delays without compromising service capacity. The reorganization of time slots enabled an optimal distribution of workload with more efficient use of resources, resulting in punctual sessions and shorter waiting times. Patient satisfaction analysis after the intervention revealed a reduction in complaints related to delays and an improved perception of efficiency in care. The application of the PDCA Cycle proved effective in optimizing the care workflow through schedule and slot adjustments. The continuous adoption of the PDCA Cycle has shown to be a resilient and adaptable strategy, promoting quality, efficiency, and safety in radiotherapy care.

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References

1. MARTIN, M. C. Radiation oncology - external-beam radiation therapy. Health Physics, v. 116, n. 2, p. 184-188, 2019.

2. SOCIEDADE BRASILEIRA DE RADIOTERAPIA (SBRT). Relatório RT2030 - Plano de desenvolvimento da radioterapia para a próxima década. SBRT, 2020. Disponível em: https://sbradioterapia.com.br/wpcontent/uploads/2021/08/Relatorio_Projeto_RT2030.pdf. Acesso em: out. 2023.

3. DEMING, W. E. Out of the Crisis. Cambridge: MIT Center for Advanced Engineering Study, 1986.

4. QIU, H.; DU, W. Evaluation of the Effect of PDCA in Hospital Health Management. Journal of Healthcare Engineering, 20 dez. 2021. Disponível em: https://doi.org/10.1155/2021/6778045.

5. LIU, X. et al. Application of PDCA Method in Quality Management of Running Medical Records at the Department of Orthopedics. Chinese Medical Record English Edition, v. 2, n. 3, p. 112–115, 2014. Disponível em: https://doi.org/10.3109/23256176.2014.910906.

6. MAGAR, V. M.; SHINDE, D. V. B. Application of 7 Quality Control (7 QC) tools for continuous improvement of manufacturing processes. International Journal of Engineering Research and General Science, v. 2, p. 364–371, 2014.

7. VIEIRA, B. et al. Improving workflow control in radiotherapy using discrete-event simulation. BMC Medical Informatics and Decision Making, v. 19, n. 1, p. 199, out. 2019. DOI: 10.1186/s12911-019-0910-0.

8. LIMPERT, E.; STAHEL, W. A.; ABBT, M. Log-normal Distributions across the Sciences: Keys and Clues.

BioScience, v. 51, n. 5, p. 341–352, maio 2001. DOI: 10.1641/0006-3568(2001)051[0341:LNDATS]2.0.CO;2.

9. KOULOULIAS, V. et al. A unique hypofractionated radiotherapy schedule with 51.3 Gy in 18 fractions three times per week for early breast cancer: outcomes including local control, acute and late skin toxicity. Breast Cancer, v. 24, n. 2, p. 263-270, abr. 2016. DOI: 10.1007/s12282-016-0697-0.

10. MAGAR, V. M.; SHINDE, D. V. B. Application of 7 Quality Control (7 QC) tools for continuous improvement of manufacturing processes. International Journal of Engineering Research and General Science, v. 2, p. 364–371, 2014.

11. GALLEGOS, R. A. P. Ferramentas de Gestão Voltadas para Melhoria da Qualidade nas Empresas. [E-book]. Rio de Janeiro: Editora Freitas Bastos, 2023.

12. NUGROHO, R. E.; MARWANTO, A.; HASIBUAN, S. Reduce product defect in stainless steel production using yield management method and PDCA. International Journal of New Technology and Research, v. 3, p. 39–46, 2017.

13. JAGUSIAK-KOCIK, M. PDCA cycle as a part of continuous improvement in the production company — A case study. Production Engineering Archives, v. 14, p. 19–22, 2017.

14. BAHADUR, Y. A. et al. Assessment of performance indicators of a radiotherapy department using an electronic medical record system. Reports of Practical Oncology and Radiotherapy, v. 22, n. 5, p. 360-367, set. -out. 2017. DOI: 10.1016/j.rpor.2017.06.002.

15. NGUYEN, V. et al. Practical Application of Plan–Do–Check– Act Cycle for Quality Improvement of Sustainable Packaging: A Case Study. Applied Sciences, v. 10, p. 6332, 2020. Disponível em: https://doi.org/10.3390/app10186332.

16. STROTMANN, C. et al. A Participatory Approach to Minimizing Food Waste in the Food Industry — A Manual for Managers. Sustainability, v. 9, p. 66, 2017. Disponível em: https://doi.org/10.3390/su9010066.

17. BEECH, R.; BURGESS, K.; STRATFORD, J. Process evaluation of treatment times in a large radiotherapy

department. Radiography, v. 22, n. 3, p. 206-216, 2016. Disponível em: https://doi.org/10.1016/j.radi.2016.03.001.

Published

2025-12-02

How to Cite

Sanches Santos, R., Ribeiro, C. E., Gonçalves de Oliveira, C. E., & Nobuyuki Itikawa, E. (2025). Optimization of Patient Care Flow in a Radiotherapy Service using the PDCA Cycle. Brazilian Journal of Medical Physics, 19, 845. https://doi.org/10.29384/rbfm.2025.v19.19849001845

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