An analytical approach to aggregate patient inflows to a simulation model over the radiotherapy process

Background In meeting input data requirements for a system dynamics (SD) model simulating the radiotherapy (RT) process, the number of patient care pathways (RT workflows) needs to be kept low to simplify the model without affecting the overall performance. A large RT department can have more than 100 workflows, which results in a complex model structure if each is to be handled separately. Here we investigated effects on model performance by reducing the number of workflows for a model of the preparatory steps of the RT process. Methods We created a SD model sub-structure capturing the preparatory RT process. Real data for patients treated in 2015-2016 at a modern RT department in Sweden were used. RT workflow similarity was quantified by averaged pairwise utilization rate differences (%) and the size of corresponding correlation coefficients (r). Grouping of RT workflows was determined using two accepted strategies (80/20 Pareto rule; merging all data into one group) and a customized algorithm with r≥0.75:0.05:0.95 as criteria for group inclusion by two strategies (A1 and A2). Number of waiting patients for each grouping strategy were compared to the reference of all workflows handled separately. Results There were 128 RT workflows for 3209 patients during the studied period. The 80/20 Pareto rule resulted in 14/8/21 groups for curative/palliative/disregarding treatment intent. Correspondingly, A1 and A2 resulted in 7-40/≤4-36/7-82 groups depending on r cutoff. Results for the Pareto rule and A2 at r≥85 were comparable to the reference. Conclusions The performance of a simulation model over the RT process will depend on the grouping strategy of patient input data. Either the Pareto rule or the grouping of patients by resource use can be expected to better reflect overall departmental effects to various changes than when merging all data into one group. Our proposed approach to identify groups based on similarity in resource use can potentially be used in any setting with variable incoming flows of objects which go through a multi-step process comparable to RT where the aim is to reduce the complexity of associated model structures without compromising with overall performance.

Needed: An opportunity for recreational therapists to have a voice in defining the RT process

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Implementing Radiation Oncology Care Plans as a foundation for process improvement

BackgroundAt The Radiation Medicine Program described, the entire radiation therapy (RT) workflow was previously conducted through the use of two electronic programs. It duplicated workflow and created a situation where it was difficult to measure the RT process. Recent enhancements to the electronic medical record facilitated the consolidation of RT planning and treatment workflows into one electronic system.PurposeThis report will describe the clinical implementation of electronic Radiation Oncology (RO) Care Plans at a Regional Cancer Centre, and how they can be applied as a foundation for RT process improvements.Impact and outcomeA total of 51 Care Plans and 95 IQ Scripts were successfully implemented. The benefits of RO Care Plans include a more streamlined process, removed ambiguity, improved communication, standardised workflow and automation of tasks. In addition, multiple performance indicators can be obtained from the RO Care Plans, such as caseload reports, workflow reports and a ‘white board’.ConclusionThe implementation of RO Care Plans serves as a foundation for data-driven process improvement at a local Regional Cancer Centre.

Bead-Based Miniature Microfluidic Systems for Rapid RNA Extraction and Reverse Transcription

The current study presents a new integrated microfluidic chip for rapid ribonucleic acid (RNA) purification, extraction and reverse transcription (RT) in an automatic fashion. The miniature system consists of two individual functional devices including a two-way microfluidic control module and a magnetic field/temperature control module. The functional microfluidic control module can perform pumping, mixing, purification and concentration of the RNA samples by incorporating with the magnetic bio-separator consisting of 2-dimension twisted microcoils. Notably, the magnetic bio-separators are developed either to perform the separation of magnetic beads or to control the temperature field for the subsequent RT process. Experimental results showed that the total RNA was successfully purified and extracted by the magnetic beads, and the subsequent RT process of RNA was completed automatically. As a whole, the developed system may provide a powerful platform for biomedical application and biological analysis.

Precision rapid mould by transferred coating

The technique of precision rapid mould by transferred coating forming is an innovative rapid tooling (RT) process. It combines many techniques such as transferred coating and rapid prototyping. The main advantages of this process compared with other RT processes are low investment and production cost, shorter production cycles and many kinds of scale tool. The manufacturing process and the coating materials have been researched. The results of application show that net shape production may be fabricated in 2–7 days. The surface roughness of tools, Ra, can reach 1.6–6.3 äm, and dimensional accuracy may attain CT4-CT6.