Impact of Proton Therapy Implementation on Processes, Patient Satisfaction, and Technology Use in a Radiation Therapy Department

IF 2.9 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2026-04-01 Epub Date: 2025-12-25 DOI:10.1016/j.adro.2025.101988

Luca Heising MSc , Thijs Ackermans PhD , Liesbeth Boersma MD, PhD , Carol Ou PhD , Geert Bosmans PhD , Rachelle Swart PhD , Andre Dekker PhD , Maria Jacobs PhD

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引用次数: 0

Abstract

Purpose

Because proton therapy (PT) can be regarded as a major radical innovation, its implementation in a radiation therapy (RT) department may have an adverse impact on processes. The current study aimed to investigate the effect of PT implementation on disruptions of clinical processes, patient satisfaction, and technology use.

Materials and methods

The study was performed in an independent Dutch RT institute, where PT was implemented in February 2019. Endpoints were (1) process disruptions, (2) patient satisfaction, and (3) technology use. Causal inference and Wilcoxon rank-sum tests in R and MATLAB were used for the analyses.

Results

After the implementation of PT, human-related errors and organizational culture-related errors in the photon therapy (PhT) process increased. Our empirical data showed more process disruptions associated with PT than with PhT. The implementation did not significantly affect patients’ satisfaction. Analysis of technology use showed a decrease in PT uptime, including treatment stagnations lasting ≥2 days. The organizational process of the entire clinic was affected in the first 13 months after PT implementation because of significantly more process disruptions in PT compared to PhT and an increase in some distinct PhT process disruptions. The decrease in PT machine uptime below 95% caused treatment stagnation with consequences for patients and staffing.

Conclusions

This study provides the first quantitative assessment of introducing PT in an ambidextrous, ambitious center that also runs PhT. Incident profiles shifted toward human-related errors in PhT and organizational issues in PT, with no lasting change in patient satisfaction. In conclusion, successful adoption requires stronger preparation and training, early patient engagement, and proactive planning for quality control, frequent updates, and lower initial uptime in partnership with vendors.

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质子治疗实施对放射治疗部门流程、患者满意度和技术使用的影响

目的由于质子治疗（PT）可被视为一项重大的突破性创新，其在放射治疗（RT）部门的实施可能会对过程产生不利影响。目前的研究旨在调查PT实施对临床过程中断、患者满意度和技术使用的影响。材料和方法该研究是在荷兰一家独立的RT研究所进行的，该研究所于2019年2月实施了PT。终点是(1)流程中断，(2)患者满意度，(3)技术使用。使用R和MATLAB中的因果推理和Wilcoxon秩和检验进行分析。结果实施光子治疗后，光子治疗过程中的人为错误和组织文化错误增加。我们的经验数据显示与PT相关的过程中断比与PhT相关的过程中断更多。实施对患者满意度无显著影响。技术使用分析显示PT正常运行时间减少，包括治疗停滞持续≥2天。在实施PT后的前13个月，整个诊所的组织流程都受到了影响，因为与PhT相比，PT的流程中断明显更多，而且一些明显的PhT流程中断有所增加。PT机器正常运行时间低于95%导致治疗停滞，对患者和人员造成后果。结论：本研究首次提供了在一个灵活、雄心勃勃的中心引入PT的定量评估。事件档案转向了医生的人为错误和医生的组织问题，患者满意度没有持久的变化。总之，成功的采用需要更强的准备和培训，早期的患者参与，积极的质量控制计划，频繁的更新，以及与供应商合作更短的初始正常运行时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.