Workflow optimization for robotic stereotactic radiotherapy treatments: Application of Constant Work In Progress workflow

We present a different organization method, a hybrid ConWIP system utilizing standardized work: managing work-in-progress instead of scheduling all steps. Discrete Event Simulations were performed before implementation in order to test the hypothesis and obtain the optimal parameters. Treatment type distribution was as follows: lung (29%), liver (21%), intracranial (13%), head and neck (11%), prostate (7%) and 20% other localizations. Implementation of this ConWIP workflow was supported by workflow software (RT-Flow) combining workflow, prioritization and load balancing. This resulted in a 32% (24%-40%) (95% CI) increase in number of treatments for the CyberKnife®installation with a negligible increase in time from CT to treatment and an improved stress load for personnel.