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Evaluation of the time required for overhead tasks performed by physicians, medical physicists, and technicians in radiation oncology institutions

The DEGRO-QUIRO study

Evaluation des Zeitaufwands für Overhead-Aufgaben bei Ärzten, Medizinphysikern und MTRA in Strahlentherapie-Institution

DEGRO-QUIRO-Studie

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Abstract

Objective

Developments in radiation oncology in recent years have highlighted the increasing deployment of personnel resources for tasks not directly related to patients. These tasks include patient-related activities such as treatment planning, reviewing files, and administrative duties (e.g., invoicing for services, documentation). The aim of the present study, part of the QUIRO project of the German Society of Radiation Oncology (DEGRO), was to describe, on the basis of valid data, the deployment of personnel resources in radiation oncology centers for “overhead” tasks.

Methods

Questionnaires were used to analyze the percentages of time needed for various tasks. The target group comprised physicians, medical physics experts (MPE), and medical technical radiology assistants (MTRA). A total of 760 personnel from 65 radio-oncology centers in the German inpatient and outpatient sector participated (32 % physicians, 23 % MPE, and 45 % MTRA).

Results

High percentages of overhead tasks during working time were measured for each of the three personnel groups considered (physicians, MPE, and MTRA). Patient-related efficiency, i.e., the percentage of working time associated directly or indirectly with the patient, was highest among MTRA and lowest among MPE. Particular features could be seen in the activity profiles of personnel in university clinics. Duties in the areas of research and teaching resulted in a greater percentage of overhead tasks for physicians and MPE. Irrespective of function (physician, MPE, or MTRA), a managerial role resulted in lower patient-related efficiency, as well as a narrower time budget for direct patient care compared with non-managerial employees.

Conclusion

Using the data gathered, it was possible to systematically investigate the time required for overhead tasks in radio-oncological centers. Overall, relatively high time requirements for a variety of overhead tasks were measured. These time requirements, generated for example by administrative duties or research and teaching, are currently not taken into adequate consideration in terms of remuneration or personnel capacity planning.

Zusammenfassung

Ziel

Die Entwicklung in der Strahlentherapie in den letzten Jahren zeigt eine zunehmende Bindung personeller Ressourcen durch Aufgaben, die nicht in einem unmittelbaren Bezug zum Patienten stehen. Dazu gehören patientennahe Aufgaben wie die Behandlungsplanung oder das Aktenstudium sowie administrative Verpflichtungen (z. B. Leistungsabrechnung, Dokumentation). Diese Studie ist Teil des QUIRO-Projekts der DEGRO mit dem Ziel, die Bindung personeller Ressourcen in strahlentherapeutischen Einrichtungen durch sog. Overhead-Tätigkeiten auf Basis valider Daten darzustellen. Die Größenordnung dieser Belastung ist bisher weitgehend unbekannt.

Methoden

Zur Analyse der Zeitanteile verschiedener Tätigkeiten wurden Fragebögen eingesetzt. Zielgruppe waren Ärzte, Medizinphysikexperten (MPE) und Medizinisch-Technische Radiologieassistenten (MTRA). Teilgenommen haben 760 Mitarbeiter aus 65 radioonkologischen Einrichtungen des stationären und ambulanten Sektors in Deutschland (davon 32 % Ärzte, 23 % MPE und 45 % MTRA).

Ergebnisse

Für jede der drei betrachteten Personalgruppen (Ärzte, MPE und MTRA) wurde ein hoher Anteil von Overhead-Tätigkeiten an der Arbeitszeit ermittelt. Der patientenbezogene Wirkungsgrad, d. h. der Anteil der Arbeitszeit, der direkt oder indirekt mit dem Patienten zusammenhängt, war für die MTRA am größten und für die Medizinphysiker am geringsten. Besonderheiten zeigten sich in den Tätigkeitsprofilen der Mitarbeiter in Universitätskliniken. Bei Ärzten und MPE führten die Verpflichtungen in den Bereichen Forschung und Lehre zu einem höheren Overhead-Anteil. Eine leitende Tätigkeit führte unabhängig von der Funktion (Arzt, MPE oder MTRA) zu einem geringeren patientenbezogenen Wirkungsgrad sowie einem geringeren Zeitbudget für die direkte Patientenversorgung im Vergleich zu nichtleitenden Angestellten.

Schlussfolgerung

Mit Hilfe der erhobenen Daten wurde der Zeitaufwand für Overhead-Tätigkeiten in strahlentherapeutischen Institutionen systematisch ermittelt. Insgesamt wurde eine relativ hohe Belastung durch verschiedene Overhead-Tätigkeiten gemessen. Diese zeitlichen Belastungen, z. B. durch administrative Verpflichtungen oder durch Forschung und Lehre, werden derzeit bei der Leistungsvergütung sowie bei der Planung personeller Kapazitäten nicht ausreichend berücksichtigt.

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Compliance with ethical guidelines

Conflict of interest

C. Sack, H. Sack, N. Willich, and W. Popp state that there is no conflict of interest. The accompanying manuscript does not include studies on humans or animals.

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Authors and Affiliations

  1. Stabsstelle Controlling, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Germany

    Cornelia Sack

  2. Department of Radiation Oncology, University of Essen, Essen, Germany

    Horst Sack

  3. Department of Radiation Oncology, University Hospital Münster, University of Münster, Münster, Germany

    Normann Willich

  4. Prime Networks AG, Basel, Germany

    Wolfgang Popp

Authors
  1. Cornelia Sack
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  2. Horst Sack
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  3. Normann Willich
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  4. Wolfgang Popp
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Corresponding author

Correspondence to Cornelia Sack.

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Sack, C., Sack, H., Willich, N. et al. Evaluation of the time required for overhead tasks performed by physicians, medical physicists, and technicians in radiation oncology institutions. Strahlenther Onkol 191, 113–124 (2015). https://doi.org/10.1007/s00066-014-0758-2

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  • DOI: https://doi.org/10.1007/s00066-014-0758-2

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